Persistent atrial standstill, characterized by absence of atrial activity on surface and intracavitary electrograms, absence of atrial mechanical activity, and inability to stimulate the atria electrically, is a rare disorder. Left atrial appendage blood flow has been reported to be related to P wave during sinus rhythm or local atrial electrogram during atrial fibrillation. However, distinct and periodical LAA blood flow was demonstrated in a patient with persistent atrial standstill by transesophageal echocardiography.