The long-term prognosis of athletes with long ventricular pauses has been unknown. In this study. thirty highly-trained cross-country skiers and 24 age-matched controls underwent 24 h Holter monitoring to detect the duration of the longest ventricular pause (LVP), and we followed the athletes for more than 3 years to evaluate prognostic significance of prolonged LVP. The LVPs of the athletes. averaged 2.2 ±0.6 sec (range 1.3-3.4), which were significantly longer than those. 1.6±0.3 sec, of the controls. In the athletes, 20 cases (66.7%) had LVPs more than 2 sec, and 5 (16.7%) showed LVPs longer than 3 sec. During 3 years follow-up, no athletes had symptoms of near syncope, syncope or death under continued heavy training. Our study suggested that athlete with pro-longed ventricular pause, even of 3 sec or more, did not have a different clinical risk than those without long pauses.