What is the clinical guidlines for pacemarker insertion due to a cardiac pause?

My father has been hospitalized with edema and cellulitis of the legs. He has been treated with IV antibiotics and diuretics and the edema is nearly resolved. He is 60 years old and has a history of moderate to severe COPD. He is NOT in CHF (nor is there any history of it) and has had a cardiac ultrasound, echocardiogram and dobutamine stress test. All tests are normal. During the course of his hospitalization, he experienced ONE episode of a 6 second pause in all cardiac activity. He was asymptomatic and his rhythm returned spontaneously. His physician is insisting he needs a pacemaker. As a healthcare professional myself, I am questioning the need for a PM due to ONE episode of a cardiac pause. He has been monitored for another 72 hours after this episode without any abnormalities. There is no history of syncope or even pre-syncope. He has yet to see the electrophysiologist, but his physician is threatening to take away his drivers license unless he has the pacemaker. This has been very upsetting to him. Even the cardiologist said his heart is fine. So my questions are: What is the rate of occurance of cardiac pause in an asymptomatic population? Is there any indication as to predictors of further arrythmia based on one pause? Is there a clinical guideline that exists as to when a pacemaker is necessary? Could the diuresis have been a source of the pause? Professional responses would be appreciated.