heart block, etc.

I am 59 yr-old woman,hypothyroid, fibromyalgia, a lupus-like syndrome, bowel problems (post-infectious IBS or maybe IBD), lack of esophageal peristalsis, etiology unknown. Have had palpitations for years, nothing has shown but 1st degree heartblock.Past year have had three episodes of absolutely irregular heart sensations with shortness of breath for five minutes or so.
  Holter monitor report: "Rhythm is sinus averaging 60, ranging 43 to 117 with heart rate briefly dropping into high 30's at night with numerous pauses, none longer than 2.5 seconds.  Supraventr. Events: averaging 6 per hour, 25 between 11 o'clock and noon.  Ventric. Events: essentially nil.  ST Depression: nil. Diary Entries: there are a number of triggered events with some diary entries times three of palpitations.  
Looking at the rhythm strips, initial event of palpitations, patient event palpitations, patient event not associated with irregularity nor ectopy. Non-conducted P wave with a two times R to R interval. See several i.e. 12 brief episodes of Wenckebach with a dropped beat every 4 to 6 beats. At slower rates there is a first degree AVB."
My question is:  I was given this report from my family doc, with a bunch of other test results. It was not signed by a cardiologist - and maybe not read - but by a local internist. (I live in a small town in Canada.)  Is there a problem with my heart? Does Wencebach mean I have 2nd degree HB? At night very often it seems to beat so slowly it panics me.
I smoke, am non-athletic,weight good,highish cholesterol,ERT for ten years since menopause.

[CCF-M.D.-MJM]

Hi Hudy,

It sounds like you have a very complicated past medical history.  IS there a problem with your heart?  It is difficult to completely assess with the information given.  You may have some mild problems with your hearts conduction system, but not significant enough to necessitate a pacemaker. Wenckebach is considered second degree type one heart block and has a benign prognosis.  Pauses of only 2.5 seconds are not an indication for a pacemaker, especially when they occur at rest.  If the pauses were very frequent and caused prolonged slowing of your heart rate with activity, a pacemaker could be considered--but this doesn't seem to apply to you.

I hope this helps answer your questions.  Good luck.