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Heart Pause and bradycardia during sleep
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Heart Pause and bradycardia during sleep

I am a 55 y/o male with a history of MVP with severe regurgitation and asymptomatic. Recently I had a 24 hour holter monitor that recorded a 3 sec. pause and a heart rate of 37 b/m while sleeping. A few months ago a 2.5 sec. pause and heart rate of 33 was found on a holter.  My question is what does all this mean? What should be done next? Would the severe mitral valve prolapse have anything to do with the heart pauses and bradycardia? Should I have a pacemaker? I am considering Mitral valve repair surgery. Can that be done without addressing the pause and slow HR or should I have a pacemaker first?
My  cardiologist said the mitral regurgitation had not caused an enlarged left atrium and is watching it for now. My LVEF is 54% with grade 1 mild diastolic dysfunction. Should I have mitral repair and who is the absolute best Mitral valve repair surgeon?? Thank you.
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