An unique case suffering from repetitive syncope episodes due to ictal asystole

We present the case of a patient with syncope with repetition over 12 years, with a clinical profile not clearly related with a cardiogenic origin, who was studied by several medical specialties without any accurate diagnosis. After subcutaneous loop recorder implantation, we were able to demonstrate how seizures acted as a trigger in the genesis of an exaggerated cardio inhibitory reflex. A new entity has been described, known as "ictal asystole", in patients with focal epilepsy mostly from the temporal lobes and has been implicated as a cardiac cause of sudden unexplained death in epilepsy. We think this case could add new information about some patients who are at high risk of death but they are misdiagnosed.