Figure 93b

Asymptomatic Bradycardia in an 18-Year-Old Male Athlete.
This electrocardiographic tracing was obtained while the patient was relaxing after lunch. The tracing shows vagally mediated sinus slowing and atrioventricular block with one junctional escape beat (pulse rates of 30 beats per minute). Similar rhythms were noted while the patient was sleeping. On the same 24-hour recording, sinus rates of more than 180 beats per minute, with a normal PR interval, were seen during exercise. No symptoms developed during long-term follow-up without therapy.

Mangrum, J.M., DiMarco, J.P., Primary Care: The Evaluation and Management of Bradycardia, The New England Journal of Medicine, Vol 342, March 9, 2000, p 703-709.