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Cardiology744 papers

Syncope anginosa

Last edited: 4/23/2026

Overview

Syncope anginosa, often referred to as vasovagal syncope (VVS), is characterized by an abrupt loss of consciousness typically triggered by emotional or physical stressors, often accompanied by bradycardia and hypotension 1 15.

Diagnosis

Clinical History: Detailed history focusing on triggers, prodromal symptoms, and recovery time 1.

Physical Examination: Assess for signs of autonomic dysfunction, heart rate variability, and orthostatic hypotension 1 15.

Electrocardiogram (ECG): Rule out arrhythmias and assess for conduction abnormalities 25.

Tilt Table Testing: Essential for confirming diagnosis, especially in suspected neurally mediated syncope 13.

Implantable Loop Recorders (ILRs): Useful for long-term monitoring in patients with unexplained syncope 7 14 18.

Baroreflex Sensitivity Testing: Can predict asystole during tilt testing in VVS patients 5.

Management

First-Line Treatments:

- Lifestyle Modifications: Increase fluid and salt intake, avoid triggers 1. - Counseling and Education: Teach patients to recognize and manage triggers 1.

Adjunctive Treatments:

- Cardioneuroablation (CNA): Emerging treatment for refractory cases, targeting ganglionated plexi 2 3 4. - Pacemakers: Considered for patients with cardioinhibitory response or significant bradycardia 61 63. - Medications: Beta-blockers or fludrocortisone for prophylaxis in severe cases 1 15.

Special Populations

Pediatrics: Most pediatric syncope is benign, but cardiac causes must be ruled out 55 64.

Elderly: Higher risk of serious outcomes; careful evaluation for underlying cardiac conditions 25 59.

Comorbidities: Patients with complete bundle branch block may require closer monitoring for arrhythmic risk 19.

Key Recommendations

Perform thorough history and physical examination to differentiate syncope types 1 15 (Evidence: Strong).

Utilize tilt table testing for definitive diagnosis of neurally mediated syncope 13 (Evidence: Strong).

Consider implantable loop recorders for unexplained syncope to identify arrhythmias 7 14 (Evidence: Moderate).

Implement cardioneuroablation as a potential treatment for refractory vasovagal syncope 2 3 (Evidence: Moderate).

Evaluate for and manage underlying cardiac conditions in elderly patients with syncope 25 59 (Evidence: Moderate).

References

Showing 100 most recent of 407 indexed papers.

1 Laurie A, Greenberg J, Greenberg J. Cardiovascular Signs and Symptoms: Syncope and Presyncope. FP essentials 2026. link 2 Minguito-Carazo C, Martínez-Alday JD, García Seara J, Martínez Sande JL, López XAF, Arias FG et al.. Simplified 3-ganglionated plexus ablation for the treatment of recurrent vasovagal syncope and functional bradyarrhythmia. Heart rhythm 2026. link 3 Skeete J, Gordon JS, Kavinksy L, Huang HD, Aksu T. Cardioneuroablation for the management of neurally mediated syncope, sinus bradycardia, and atrioventricular block. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2025. link 4 Aksu T, Tung R, De Potter T, Markman TM, Santangeli P, du Fay de Lavallaz J et al.. Cardioneuroablation for the management of patients with recurrent vasovagal syncope and symptomatic bradyarrhythmias: the CNA-FWRD Registry. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2025. link 5 Russo V, Comune A, Parente E, Colalillo N, Pecori F, Valentino GB et al.. Baroreflex Sensitivity Predicts the Head-Up Tilt Test Induced Asystole Among Patients With Suspected Vasovagal Syncope. The American journal of cardiology 2025. link 6 Aksu T, Yalin K, Mutluer FO, Farhat K, Tanboga HI, Po SS et al.. The impact of the clinical diagnosis on the vagal response and heart rate after ganglionated plexus ablation. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2025. link 7 Letsas KP, Saplaouras A, Mililis P, Kariki O, Bazoukis G, Archontakis S et al.. Diagnostic yield of implantable loop recorders: results from the hellenic registry. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2025. link 8 Cwalina P, Rutig N, Turkiewicz N, Budzikowski AS. Coexistence of R-Wave Oversensing and Undersensing in an Implantable Loop Recorder: The Issue of Multiple Sensing in Implantable Loop Recorders. The American journal of case reports 2025. link 9 D'Innocenzo R, Sethi A, Uribe-Rivera A, Dang RR, Cook A, Joshi P et al.. Medical emergencies in a dental school clinic - A 12-year review and lessons learned. Journal of dental education 2024. link 10 Woo EJ, Miller ER, Stroud E. Syncope after live attenuated influenza vaccine: Reports to the Vaccine Adverse Event Reporting System (2003-2024). Vaccine 2024. link 11 Chakraborty P, Chen PS, Gollob MH, Olshansky B, Po SS. Potential consequences of cardioneuroablation for vasovagal syncope: A call for appropriately designed, sham-controlled clinical trials. Heart rhythm 2024. link 12 Staples JA, Erdelyi S, Merchant K, Yip C, Khan M, Maclure KM et al.. Syncope and Traffic Crash: A Population-Based Case-Crossover Analysis. The Canadian journal of cardiology 2024. link 13 van Zanten S, Sutton R, Hamrefors V, Fedorowski A, de Lange FJ. Tilt table testing, methodology and practical insights for the clinic. Clinical physiology and functional imaging 2024. link 14 Bučić D, Hrabak-Paar M. Multimodality imaging in patients with implantable loop recorders: Tips and tricks. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2024. link 15 Longo S, Legramante JM, Rizza S, Federici M. Vasovagal syncope: An overview of pathophysiological mechanisms. European journal of internal medicine 2023. link 16 Marai I, Steier J, Novic L, Sakhnini A, Grosman-Rimon L, Tzadok B. Does the Initial Screening of Syncope in the Emergency Department and During Hospitalization Adhere to ESC Guidelines?. The Israel Medical Association journal : IMAJ 2023. link 17 van Zanten S, de Jong JSY, Scheffer MG, Kaal ECA, de Groot JR, de Lange FJ. A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2023. link 18 Ghariq M, van den Hout WB, Dekkers OM, Bootsma M, de Groot B, Groothuis JGJ et al.. Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study). BMC medicine 2023. link 19 Francisco-Pascual J, Rivas-Gándara N, Maymi-Ballesteros M, Badia-Molins C, Bach-Oller M, Benito B et al.. Arrhythmic risk in single or recurrent episodes of unexplained syncope with complete bundle branch block. Revista espanola de cardiologia (English ed.) 2023. link 20 Torabi P, Hamrefors V, Sutton R, Brignole M, Fedorowski A. Definitive aetiology of unexplained syncope after cardiovascular autonomic tests in a tertiary syncope unit. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2023. link 21 Vandenberk B, Lei LY, Ballantyne B, Vickers D, Liang Z, Sheldon RS et al.. Cardioneuroablation for vasovagal syncope: A systematic review and meta-analysis. Heart rhythm 2022. link 22 Zaboli A, Ausserhofer D, Sibilio S, Paulmichl R, Toccolini E, Losi C et al.. Nurse triage accuracy in the evaluation of syncope according to European Society of Cardiology guidelines. European journal of cardiovascular nursing 2022. link 23 du Fay de Lavallaz J, Zimmermann T, Badertscher P, Lopez-Ayala P, Nestelberger T, Miró Ò et al.. Performance of the American Heart Association/American College of Cardiology/Heart Rhythm Society versus European Society of Cardiology guideline criteria for hospital admission of patients with syncope. Heart rhythm 2022. link 24 Zachar JJ, Reher P. Frequency and characteristics of medical emergencies in an Australian dental school: A retrospective study. Journal of dental education 2022. link 25 Bo M, Del Rosso A. Syncope and electrocardiogram. Minerva medica 2022. link 26 Sheldon R, Talajic M, Tang A, Becker G, Essebag V, Sultan O et al.. Randomized Pragmatic Trial of Pacemaker Versus Implantable Cardiac Monitor in Syncope and Bifascicular Block. JACC. Clinical electrophysiology 2022. link 27 Eftekhari H, He H, Lee JD, Paul G, Zhupaj A, Lachlan T et al.. Safety and outcome of nurse-led syncope clinics and implantable loop recorder implants. Heart rhythm 2022. link 28 Carretta DM, Troccoli R, Dentico A, De Vita M, Spadaro Guerra A, Giacopelli D et al.. Remote assessment of QT interval: A new perspective for implantable cardiac monitors. Journal of electrocardiology 2022. link 29 Gopinathannair R, Lakkireddy D, Afzal MR, Piorkowski C, Qu F, Dawoud F et al.. Effectiveness of SharpSense™ algorithms in reducing bradycardia and pause detection: real-world performance in Confirm Rx™ insertable cardiac monitor. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2022. link 30 Deharo JC, Brignole M, Guieu R. Adenosine and neurohumoral syncope. Minerva medica 2022. link 31 Smyth S, Gupta V, Williams M, Cowley A, Sirrine M, Surratt H et al.. Identifying Guideline-Practice Gaps to Optimize Evaluation and Management for Patients With Syncope. The Canadian journal of cardiology 2021. link 32 Ghariq M, van Bodegom-Vos L, Brignole M, Peeters SYG, de Groot B, Kaal ECA et al.. Factors facilitating and hindering the implementation of the European Society of Cardiology Syncope Guidelines at the Emergency Department: A nationwide qualitative study. International journal of cardiology 2021. link 33 Winder MM, Marietta J, Kerr LM, Puchalski MD, Zhang C, Ware AL et al.. Reducing Unnecessary Diagnostic Testing in Pediatric Syncope: A Quality Improvement Initiative. Pediatric cardiology 2021. link 34 Sorenson AD, Marusko RM, Kennedy KS. Medical emergencies in the dental school setting. Journal of dental education 2021. link 35 Aksu T, Yalin K, John L, Osorio J, Winterfield J, Aras D et al.. Effect of conscious sedation and deep sedation on the vagal response characteristics during ganglionated plexus ablation. Journal of cardiovascular electrophysiology 2021. link 36 Hutse I, Coppens M, Herbelet S, Seyssens L, Marks L. Syncope in Dental Practices: A Systematic Review on Aetiology and Management. The journal of evidence-based dental practice 2021. link 37 Trivedi MK, Arora G. Micturition syncope with asystole in a paediatric patient. Cardiology in the young 2021. link 38 Kajdič N, Zupan Mežnar A, Šinkovec M, Žižek D. Diagnostic yield of implantable loop recorders in patients with unexplained syncope: single-center experience. Minerva cardiology and angiology 2021. link 39 Chionchio A, Kim BS, Chang D, Gabriels J, Devanabanda A, Willner J et al.. Loop Recorder Implantation on a Telemetry Ward. The American journal of cardiology 2020. link 40 Sandhu RK, Raj SR, Thiruganasambandamoorthy V, Kaul P, Morillo CA, Krahn AD et al.. Canadian Cardiovascular Society Clinical Practice Update on the Assessment and Management of Syncope. The Canadian journal of cardiology 2020. link 41 Dan GA, Scherr D, Jubele K, Farkowski MM, Iliodromitis K, Conte G et al.. Contemporary management of patients with syncope in clinical practice: an EHRA physician-based survey. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2020. link 42 Nickerson J, Taub ES, Shah K. A checklist manifesto: Can a checklist of common diagnoses improve accuracy in ECG interpretation?. The American journal of emergency medicine 2020. link 43 Jing Q, Wan K, Ma L, Zhao JZ. Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China. Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih 2020. link 44 Al-Busaidi IS, Jardine DL. Different Types of Syncope Presenting to Clinic: Do We Miss Cardiac Syncope?. Heart, lung & circulation 2020. link 45 Numeroso F, Mossini G, Lippi G, Cervellin G. Emergency department management of patients with syncope according to the 2018 ESC guidelines: Main innovations and aspect deserving a further improvement. International journal of cardiology 2019. link 46 Hu F, Zheng L, Liang E, Ding L, Wu L, Chen G et al.. Right anterior ganglionated plexus: The primary target of cardioneuroablation?. Heart rhythm 2019. link 47 Smereka J, Aluchna M, Aluchna A, Puchalski M, Wroblewski P, Checinski I et al.. Medical emergencies in dental hygienists' practice. Medicine 2019. link 48 Smereka J, Aluchna M, Aluchna A, Szarpak Ł. Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists. International dental journal 2019. link 49 White JL, Chang AM, Hollander JE, Su E, Weiss RE, Yagapen AN et al.. QTc prolongation as a marker of 30-day serious outcomes in older patients with syncope presenting to the Emergency Department. The American journal of emergency medicine 2019. link 50 Roca-Luque I, Francisco-Pasqual J, Oristrell G, Rodríguez-García J, Santos-Ortega A, Martin-Sanchez G et al.. Flecainide Versus Procainamide in Electrophysiological Study in Patients With Syncope and Wide QRS Duration. JACC. Clinical electrophysiology 2019. link 51 Yau L, Mukarram MA, Kim SM, Arcot K, Thavorn K, Stiell IG et al.. Outcomes and emergency medical services resource utilization among patients with syncope arriving to the emergency department by ambulance. CJEM 2019. link 52 Chang AM, Hollander JE, Su E, Weiss RE, Yagapen AN, Malveau SE et al.. Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes. The American journal of emergency medicine 2019. link 53 Coleman DK, Long B, Koyfman A. Clinical Mimics: An Emergency Medicine-Focused Review of Syncope Mimics. The Journal of emergency medicine 2018. link 54 Probst MA, Hess EP, Breslin M, Frosch DL, Sun BC, Langan MN et al.. Development of a Patient Decision Aid for Syncope in the Emergency Department: the SynDA Tool. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2018. link 55 Schunk PC, Ruttan T. Pediatric Syncope: High-Risk Conditions and Reasonable Approach. Emergency medicine clinics of North America 2018. link 56 Martin-Gill C, Doyle TJ, Yealy DM. In-Flight Medical Emergencies: A Review. JAMA 2018. link 57 Roston TM, Tran DT, Sanatani S, Sandhu R, Sheldon R, Kaul P. A Population-Based Study of Syncope in the Young. The Canadian journal of cardiology 2018. link 58 Emren V, Kocabaş U. Is heart rate recovery index a predictive factor for cardioinhibitory syncope?. Kardiologia polska 2018. link 59 Barón-Esquivias G, Fernández-Cisnal A, Arce-León Á, Toro R, Cantero-Pérez E, Parejo-Matos J et al.. Prognosis of patients with syncope seen in the emergency room department: an evaluation of four different risk scores recommended by the European Society of Cardiology guidelines. European journal of emergency medicine : official journal of the European Society for Emergency Medicine 2017. link 60 Sanatani S, Chau V, Fournier A, Dixon A, Blondin R, Sheldon RS. Canadian Cardiovascular Society and Canadian Pediatric Cardiology Association Position Statement on the Approach to Syncope in the Pediatric Patient. The Canadian journal of cardiology 2017. link 61 Varosy PD, Chen LY, Miller AL, Noseworthy PA, Slotwiner DJ, Thiruganasambandamoorthy V. Pacing as a Treatment for Reflex-Mediated (Vasovagal, Situational, or Carotid Sinus Hypersensitivity) Syncope: A Systematic Review for the 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology 2017. link 62 Arnold AC, Ng J, Lei L, Raj SR. Autonomic Dysfunction in Cardiology: Pathophysiology, Investigation, and Management. The Canadian journal of cardiology 2017. link 63 Varosy PD, Chen LY, Miller AL, Noseworthy PA, Slotwiner DJ, Thiruganasambandamoorthy V. Pacing as a treatment for reflex-mediated (vasovagal, situational, or carotid sinus hypersensitivity) syncope: A systematic review for the 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart rhythm 2017. link 64 Fant C, Cohen A. Syncope In Pediatric Patients: A Practical Approach To Differential Diagnosis And Management In The Emergency Department. Pediatric emergency medicine practice 2017. link 65 Yeo C, Tan VH, Wong KC. Exercise-induced syncope in a 22-year-old man. Heart (British Cardiac Society) 2017. link 66 Zhang Q, Li Y, Liao Y, Du J. Significance of red cell distribution width in the differential diagnosis between neurally mediated syncope and arrhythmic syncope in children. Cardiology in the young 2017. link 67 Han SK, Yeom SR, Lee SH, Park SC, Kim HB, Cho YM et al.. Transthoracic echocardiogram in syncope patients with normal initial evaluation. The American journal of emergency medicine 2017. link 68 Brignole M, Guieu R, Tomaino M, Iori M, Ungar A, Bertolone C et al.. Mechanism of syncope without prodromes with normal heart and normal electrocardiogram. Heart rhythm 2017. link 69 Dutton E, Dukes-McEwan J, Cripps PJ. Serum cardiac troponin I in canine syncope and seizures. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2017. link 70 Prabhu MA, Pillai V, Shenthar J. Comparison of Efficacy, Pattern of Response, Occurrence of Arrhythmias, and the Tolerability of Nitroglycerine and Isoprenaline as Provocative Drugs During Head-Up Tilt Test. Heart, lung & circulation 2017. link 71 Paris Y, Toro-Salazar OH, Gauthier NS, Rotondo KM, Arnold L, Hamershock R et al.. Regional Implementation of a Pediatric Cardiology Syncope Algorithm Using Standardized Clinical Assessment and Management Plans (SCAMPS) Methodology. Journal of the American Heart Association 2016. link 72 Phelps HM, Sachdeva R, Mahle WT, McCracken CE, Kelleman M, McConnell M et al.. Syncope Best Practices: A Syncope Clinical Practice Guideline to Improve Quality. Congenital heart disease 2016. link 73 Numeroso F, Mossini G, Giovanelli M, Lippi G, Cervellin G. Short-term Prognosis and Current Management of Syncopal Patients at Intermediate Risk: Results from the IRiS (Intermediate-Risk Syncope) Study. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2016. link 74 Sulke N, Sugihara C, Hong P, Patel N, Freemantle N. The benefit of a remotely monitored implantable loop recorder as a first line investigation in unexplained syncope: the EaSyAS II trial. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 75 Banerjee MM, Ramesh Iyer V, Nandi D, Vetter VL, Banerjee A. Reliability of Left Ventricular Hypertrophy by ECG Criteria in Children with Syncope: Do the Criteria Need to be Revised?. Pediatric cardiology 2016. link 76 Saal DP, Thijs RD, van Dijk JG. Tilt table testing in neurology and clinical neurophysiology. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 2016. link 77 Zyśko D, Fedorowski A, Nilsson D, Rudnicki J, Gajek J, Melander O et al.. Tilt testing results are influenced by tilt protocol. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 78 Locati ET, Moya A, Oliveira M, Tanner H, Willems R, Lunati M et al.. External prolonged electrocardiogram monitoring in unexplained syncope and palpitations: results of the SYNARR-Flash study. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. link 79 Sau A, Mereu R, Taraborrelli P, Dhutia NM, Willson K, Hayat SA et al.. A long-term follow-up of patients with prolonged asystole of greater than 15s on head-up tilt testing. International journal of cardiology 2016. link 80 Lim RY, Mulcahy H, Keane D. Association of Oesophageal Hypertension with Bradycardia Mediated Deglutition Syncope. Irish medical journal 2015. link 81 Fujii-Abe K, Uriu K, Kawahara H. Case of Vasovagal Syncope With Asystole Associated With Propofol Sedation. Anesthesia progress 2015. link 82 Zyśko D, Szewczuk-Bogusławska M, Kaczmarek M, Agrawal AK, Rudnicki J, Gajek J et al.. Reflex syncope, anxiety level, and family history of cardiovascular disease in young women: case-control study. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2015. link 83 Christ M, Geier F, Popp S, Singler K, Smolarsky A, Bertsch T et al.. Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope. The American journal of medicine 2015. link 84 Laranjo S, Tavares C, Oliveira M, Trigo C, Pinto F, Rocha I. An insight into the autonomic and haemodynamic mechanisms underlying reflex syncope in children and adolescents: a multiparametric analysis. Cardiology in the young 2015. link 85 Cruz-Gonzalez I, Perez-Rivera JA, Bethencourt A. Recurrent syncope after left atrial appendage occlusion. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2015. link 86 Bruno E, Guillermo D, Eduardo JM, Horacio SM. An early literary description of emotional syncope in the Fifth Canto of Dante Alighieri's Commedia: 'E caddi come corpo morto cade'. Journal of cardiovascular medicine (Hagerstown, Md.) 2014. link 87 Johnson ER, Etheridge SP, Minich LL, Bardsley T, Heywood M, Menon SC. Practice variation and resource use in the evaluation of pediatric vasovagal syncope: are pediatric cardiologists over-testing?. Pediatric cardiology 2014. link 88 Sruamsiri K, Chenthanakij B, Tantiwut A, Wittayachamnankul B. Usefulness of syncope guidelines in risk stratification of syncope in emergency department. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 2014. link 89 Patel VJ, Ahmed SS, Nitu ME, Rigby MR. Vasovagal syncope and severe bradycardia following intranasal dexmedetomidine for pediatric procedural sedation. Paediatric anaesthesia 2014. link 90 Halliwill JR, Sieck DC, Romero SA, Buck TM, Ely MR. Blood pressure regulation X: what happens when the muscle pump is lost? Post-exercise hypotension and syncope. European journal of applied physiology 2014. link 91 Sutton R, Salukhe TV, Franzen-McManus AC, Collins A, Lim PB, Francis DP. Ivabradine in treatment of sinus tachycardia mediated vasovagal syncope. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2014. link 92 Sucu M, Ercan S, Uku O, Davutoglu V, Altunbas G. Atrial electromechanical conduction delay in patients with neurocardiogenic syncope. Pacing and clinical electrophysiology : PACE 2014. link 93 Ungar A, Rafanelli M, Cellai T, Ceccofiglio A, Del Rosso A, Mussi C et al.. Poor diagnostic performance of tilt testing in hypertensive patients with unexplained syncope. Journal of human hypertension 2014. link 94 Locati ET, Vecchi AM, Vargiu S, Cattafi G, Lunati M. Role of extended external loop recorders for the diagnosis of unexplained syncope, pre-syncope, and sustained palpitations. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2014. link 95 Brignole M, Donateo P, Tomaino M, Massa R, Iori M, Beiras X et al.. Benefit of pacemaker therapy in patients with presumed neurally mediated syncope and documented asystole is greater when tilt test is negative: an analysis from the third International Study on Syncope of Uncertain Etiology (ISSUE-3). Circulation. Arrhythmia and electrophysiology 2014. link 96 Solari D, Maggi R, Oddone D, Solano A, Croci F, Donateo P et al.. Clinical context and outcome of carotid sinus syndrome diagnosed by means of the 'method of symptoms'. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2014. link 97 Thiruganasambandamoorthy V, Stiell IG, Sivilotti ML, Murray H, Rowe BH, Lang E et al.. Risk stratification of adult emergency department syncope patients to predict short-term serious outcomes after discharge (RiSEDS) study. BMC emergency medicine 2014. link 98 Ruwald MH, Hansen ML, Lamberts M, Hansen CM, Numé AK, Vinther M et al.. Comparison of incidence, predictors, and the impact of co-morbidity and polypharmacy on the risk of recurrent syncope in patients <85 versus ≥85 years of age. The American journal of cardiology 2013. link 99 Ruwald MH, Hansen ML, Lamberts M, Hansen CM, Vinther M, Køber L et al.. Prognosis among healthy individuals discharged with a primary diagnosis of syncope. Journal of the American College of Cardiology 2013. link 100 Ofman P, Rahilly-Tierney C, Djousse L, Peralta A, Hoffmeister P, Gaziano JM et al.. Pacing system malfunction is a rare cause of hospital admission for syncope in patients with a permanent pacemaker. Pacing and clinical electrophysiology : PACE 2013. link

Original source

[1]
Cardiovascular Signs and Symptoms: Syncope and Presyncope. — Laurie A, Greenberg J, Greenberg J FP essentials (2026)
[2]
Simplified 3-ganglionated plexus ablation for the treatment of recurrent vasovagal syncope and functional bradyarrhythmia. — Minguito-Carazo C, Martínez-Alday JD, García Seara J, Martínez Sande JL, López XAF, Arias FG et al. Heart rhythm (2026)
[3]
Cardioneuroablation for the management of neurally mediated syncope, sinus bradycardia, and atrioventricular block. — Skeete J, Gordon JS, Kavinksy L, Huang HD, Aksu T Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (2025)
[4]
Cardioneuroablation for the management of patients with recurrent vasovagal syncope and symptomatic bradyarrhythmias: the CNA-FWRD Registry. — Aksu T, Tung R, De Potter T, Markman TM, Santangeli P, du Fay de Lavallaz J et al. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (2025)
[5]
Baroreflex Sensitivity Predicts the Head-Up Tilt Test Induced Asystole Among Patients With Suspected Vasovagal Syncope. — Russo V, Comune A, Parente E, Colalillo N, Pecori F, Valentino GB et al. The American journal of cardiology (2025)
[6]
The impact of the clinical diagnosis on the vagal response and heart rate after ganglionated plexus ablation. — Aksu T, Yalin K, Mutluer FO, Farhat K, Tanboga HI, Po SS et al. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing (2025)
[7]
Diagnostic yield of implantable loop recorders: results from the hellenic registry. — Letsas KP, Saplaouras A, Mililis P, Kariki O, Bazoukis G, Archontakis S et al. Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese (2025)
[8]
Coexistence of R-Wave Oversensing and Undersensing in an Implantable Loop Recorder: The Issue of Multiple Sensing in Implantable Loop Recorders. — Cwalina P, Rutig N, Turkiewicz N, Budzikowski AS The American journal of case reports (2025)
[9]
Medical emergencies in a dental school clinic - A 12-year review and lessons learned. — D'Innocenzo R, Sethi A, Uribe-Rivera A, Dang RR, Cook A, Joshi P et al. Journal of dental education (2024)
[10]
Syncope after live attenuated influenza vaccine: Reports to the Vaccine Adverse Event Reporting System (2003-2024). — Woo EJ, Miller ER, Stroud E Vaccine (2024)
[11]
Potential consequences of cardioneuroablation for vasovagal syncope: A call for appropriately designed, sham-controlled clinical trials. — Chakraborty P, Chen PS, Gollob MH, Olshansky B, Po SS Heart rhythm (2024)
[12]
Syncope and Traffic Crash: A Population-Based Case-Crossover Analysis. — Staples JA, Erdelyi S, Merchant K, Yip C, Khan M, Maclure KM et al. The Canadian journal of cardiology (2024)
[13]
Tilt table testing, methodology and practical insights for the clinic. — van Zanten S, Sutton R, Hamrefors V, Fedorowski A, de Lange FJ Clinical physiology and functional imaging (2024)
[14]
Multimodality imaging in patients with implantable loop recorders: Tips and tricks. — Bučić D, Hrabak-Paar M Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese (2024)
[15]
Vasovagal syncope: An overview of pathophysiological mechanisms. — Longo S, Legramante JM, Rizza S, Federici M European journal of internal medicine (2023)
[16]
Does the Initial Screening of Syncope in the Emergency Department and During Hospitalization Adhere to ESC Guidelines? — Marai I, Steier J, Novic L, Sakhnini A, Grosman-Rimon L, Tzadok B The Israel Medical Association journal : IMAJ (2023)
[17]
A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices. — van Zanten S, de Jong JSY, Scheffer MG, Kaal ECA, de Groot JR, de Lange FJ Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (2023)
[18]
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