Case Report Treatment of Malignant Vasovagal Syncope with Dual-chamber Rate-drop Response Pacemaker: A Case Report

A 39-year-old male was referred to our hospital because of presyncope and syncope. During head-up tilt table test a marked cardioinhibitory response was observed. Treatment with oral atenolol and theophylline was insufficient in prevention of syncopes. A dual-chamber pacemaker w ith rate-drop response algorithm was implanted and oral drugs were continued for presyncope episodes. The patient was successfully treated with permanent pacemaker, and he did not have any syncopal episodes during 22 months, follow-up period. Patients with malignant vasovagal syncope who are refractory to conservative therapy, may be successfully treated by implantation of a dua! chamber rate-drop response pacemaker.