Pacemaker

Pacemaker

Occasionally permanent pacemaker implantation is necessary – generally when tilt table testing elicits prolonged cardiac standstill.

The vast majority of scientific trials looking at the effectiveness of cardiac pacing as a treatment for neurocardiogenic syncope have not been placebo controlled. However, one recent trial – Second Vasovagal Pacemaker Study (VPS II 2003) was double-blinded and showed no benefit from pacing once the placebo effect was removed.
Unfortunately this trial did not look specifically at the group most likely to benefit from pacing – those with significant cardiac standstill on provoked syncope.