Editorial
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World J Cardiol. Oct 26, 2010; 2(10): 308-315
Published online Oct 26, 2010. doi: 10.4330/wjc.v2.i10.308
Management and therapy of vasovagal syncope: A review
Muhammet Ali Aydin, Tushar V Salukhe, Iris Wilke, Stephan Willems
Muhammet Ali Aydin, Tushar V Salukhe, Iris Wilke, Stephan Willems, Department of Electrophysiology, University Heart Center Hamburg, Martinistraße 52, Hamburg 20246, Germany
Author contributions: Aydin MA, Salukhe TV, Wilke I and Willems S wrote the manuscript.
Correspondence to: Muhammet Ali Aydin, MD, Department of Electrophysiology, University Heart Center Hamburg, Martinistraße 52, Hamburg 20246, Germany. aydin@uke.de
Telephone: +40-7410-54120 Fax: +40-7410-58570
Received: May 12, 2010
Revised: August 12, 2010
Accepted: August 19, 2010
Published online: October 26, 2010
Abstract

Vasovagal syncope is a common cause of recurrent syncope. Clinically, these episodes may present as an isolated event with an identifiable trigger, or manifest as a cluster of recurrent episodes warranting intensive evaluation. The mechanism of vasovagal syncope is incompletely understood. Diagnostic tools such as implantable loop recorders may facilitate the identification of patients with arrhythmia mimicking benign vasovagal syncope. This review focuses on the management of vasovagal syncope and discusses the non-pharmacological and pharmacological treatment options, especially the use of midodrine and selective serotonin reuptake inhibitors. The role of cardiac pacing may be meaningful for a subgroup of patients who manifest severe bradycardia or asystole but this still remains controversial.

Keywords: Vasovagal syncope, Midodrine, Adrenergic β-antagonists, Serotonin uptake inhibitors