Hi Evizza. Had a chat with a GP and she said since my previous holter had been ok apart from a few ectopics and what seems to be postural tachycardia, I likely have pronounced sinus arrhythmia which is a natural variation from breathing. Mine is just sometimes extra long. I do have an irregular heartbeat anyway, but they didn't seem concerned about the long pause. She didn't want to look at the watch ECG as she said they're not reliable enough and she would rather go by my previous tests. I asked about the long sinus pause and she said if I start feeling bad symptoms with the pause, to see her, but otherwise just get on with life.
I also was able to sort of replicate the pause when I really tensed my stomach and breathed out heavy after a workout, got a super long pause, so it could be the vagus nerve (which can send signals to the heart and it runs from your head to stomach) acting up and causing the pause. It apparently happens often with athletes. I'm unfit though, but working on it. I really have no definitive answer, but my GP wasn't too concerned about it and I'm just working on being healthy. She didn't say it wasn't an SA block, but she didn't think it needed looking into either.
If it is an SA block, for the most part they are benign, though they can progress in older age as the nerves wear down and require a pacemaker as the pauses get longer and slow the heartrate more and more. Your holter will probably tell you a lot and rule that out because it tends to show up in a recognizable pattern. Most abnormal rhythms are easy to spot on a holter as it gives way more detailed readings than a little watch ecg, so you should have answers very soon
Last edited by WorryRaptor; 22-02-21 at 08:41.
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