[The prolonged asystole during head down tilt test: prognostic significance and therapy]

The head up tilt test is a worthy of acknowledgment and widely accepted tool used in diagnosing patients with syncope of unknown origin. In some cases tilting provokes asystole lasting even several tens of seconds. Not long ago this kind of vasovagal reaction was being associated with appearance of syncope combined with body injures. The prognostic significance of asystole during head-up tilt test and the safe and efficacious way of therapy in such cases hasn't been established yet. There were three cases of vasovagal reaction, resulting in asystole, described in order to show a large number of diagnostic and therapeutic problems related to the discussed syndrome. The presentation of actual views on diagnosing and therapy of patients with vasovagal syndrome, as a matter of fact is a synthesis of published results of clinical studies and its aim is to be more objective about so many obliging theories.