The Current Indication for Pacemaker in Patients with Cardioinhibitory Vasovagal Syncope Alternate Title: Pacemaker for Vasovagal Syncope

Rose Mary Ferreira Lisboa da Silva*
Department of Internal Medicine, Faculty of Medicine, UFMG-Federal University of Minas Gerais, Belo Horizonte, Brazil

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Creative Commons License
© Rose Mary Ferreira Lisboa da Silva; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Avenue Alfredo Balena, 190, room 246, Santa Efigênia, Code 30.130-100, Belo Horizonte/Minas Gerais, Brazil; Tel: + 5531 – 3409-9746; E-mail:


The most frequent cause of syncope is vasovagal reflex. It is associated with worse quality of life, depression, fatigue and physical injury. Recurrence of vasovagal syncope is an aggravating, reaching the rate of 69%. Initial step and pharmacological treatment may not work, especially in patients with recurrent syncope without prodrome. These patients can present cardioinhibitory response with asystole. Studies were designed to analyses the effectiveness of pacemaker for prevention of syncope. In this review, nonrandomized clinical trials, open-label randomized, double-blind randomized, placebo-controlled, and studies based on tilt test or Implantable Loop Recorder findings will be discussed.

Keywords: Asystole, Cardioinhibitory syncope, Implantable loop recorder, Pacemaker, Tilt test, Vasovagal syncope.