A slowing economist’s rate

A 47-year-old economist is referred for a routine executive health check.

He feels fine with no symptoms at all and has no cardiac risk factors. He works out regularly and jogs 5km twice a week without any limitation.

On examination he has a slow pulse rate of 48 beats per minute. His BP is 120/80. Examination  is otherwise normal. Pathology including thyroid function tests are normal.

The above ECG is recorded.

A subsequent