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Updated: Feb 23, 2026

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Role of closed loop stimulation pacing (CLS) in vasovagal syncope
Mohammed Ruzieh1, Zaid Ammari1, Osama Dasa1
1Department of Internal Medicine, University of Toledo, Toledo, OH, USA.
Abstract:
Vasovagal syncope (VVS) or neurocardiogenic syncope is defined by transient loss of consciousness with spontaneous and rapid recovery. Recently, a closed loop stimulation (CLS) pacing system has emerged as a new strategy which appears superior to conventional pacing for patients with refractory syncope. However, its efficacy remains of considerable debate and large randomized controlled clinical trials are needed. Between 2002 and 2017, 12 total studies evaluated the use of CLS pacing in patients with refractory VVS, and are summarized in this article.
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