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Heart transplantation is the gold standard for treatment of end stage heart failure. Atrial parasystole (AP), defined as the presence of an additional dissociated atrial pacemaker on a surface electrocardiogram, has been described to be seen after heart transplantation using biatrial surgical technique. AP may pose a challenge in diagnosing underlying rhythm disturbances in these patients. Here, we report a rare phenomenon of junctional escape rhythm with sinus node dysfunction, mimicking as complete atrioventricular block due to the presence of an AP, in a heart transplant recipient.