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We report a case of atrioventricular junction (AVJ) pacing in a patient with Ebstein's anomaly (EA). The patient was a 68-year-old man who suffered from pacemaker syndrome and complained of heart failure symptoms. He was initially diagnosed with EA in his thirties and received right ventricular (RV) apex pacing for safe during a surgery because of low heart rate atrial fibrillation (AF) 9 years ago. However, since the patient felt discomfort, the pacing rate was then programed down to 45-55 per/min. During recent years, he was often