Next question, again, another case. This is a 43-year-old woman with type 1 myotonic dystrophy. She has palpitations and worsening exertional fatigue and is undergoing exercise stress. She exercised for nine minutes and the ECGs are shown below. At rest during stage two of exercise and one minute after exercise. Echocardiography revealed normal basal function and normal augmentation of all regions of the left ventricle. She's been treated with myxilatine, which significantly improved her symptoms of myotonia and dysphagia. Which of the following is the most appropriate next step? A, discontinuation of myxilatine. B, implantation of a pacemaker. C, implantation of an implantable loop recorder. Or D, continued routine follow-up. And let me allow you to consider these answers as well.

myotonic dystrophy

palpitations

exertional fatigue

myxilatine

pacemaker