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Updated: Sep 8, 2025

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Published on: March 21, 2013
Pacing for vasovagal syncope: Tips for use in practice
Carlos A Morillo1, Michele Brignole1
1Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Canada; IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, Faint & Fall Programme, Ospedale San Luca, Milano, MB, Italy.
Abstract:
Vasovagal syncope (VVS) continues to be the most frequent cause of syncope in all age groups. Recent randomized double-blinded trials (RCTs) provide further support for pacing in selected cases of patients with recurrent refractory VVS with significant cardio-inhibitory response either documented spontaneously or induced during head-up tilt testing (HUTT). Cardiac pacing is the only therapy of proven efficacy for the predominant cardio-inhibitory phenotype of vasovagal (reflex) syncope; however, several questions regarding the best candidates remain. The current review focuses on practical tips for use of cardiac pacing in practice.
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