TG and hypothyroidism: Sinus pause, if asymptomatic, can be ignored but if symptomatic it may be because of the degeneration of SA nodal cells, myocardial infarction, antiarrhythmic drugs (beta-blockers calcium channel blockers, digitalis), high blood potassium (hyperkalemia), low-level thyroid hormone in the blood (hypothyroidism), sleep apnea and thorough investigation is required to find the exact cause (Gregoratos, 2003).