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Asystole &gt;3 s or sinus bradycardia with a ventricular rate &lt;40 in association with complete heart block or sinus node dysfunction are considered to be Class 1 indications for permanent cardiac pacing. Nevertheless, these phenomena may be observed in symptomatic patients with neurocardiogenic syncope, who may not respond to pacing therapy. We hypothesized that the pattern of spontaneous bradycardia in symptomatic patients would distinguish patients with sinus node dysfunction or conduction system disease who would benefit from pacing from patients with neurally-mediated syncope who would derive lesser benefit.

Implications of mechanism of bradycardia on response to pacing in patients with unexplained syncope