A 3 month-old infant s/p complete AV canal defect repair is recovering in the first postoperative night in the cardiac intensive care unit. He develops junctional ectopic tachycardia with a narrow pulse pressure and hypotension. The participant will be expected to recognize and diagnose the arrhythmia and provide therapies to improve the cardiac output including volume resuscitation, overdrive pacing, and measures to reduce drivers of the arrhythmia. If they increase inotropes or mismanage the arrhythmia the patient will become progressively hypotensive.