Sleep Syncope: Treatment with a Permanent Pacemaker

Vasovagal syncope usually occurs during upright posture, but Jardine et al. have described a variant that occurs at night. During “sleep syncope” patients are awakened from sleep with nausea, abdominal cramping, or a sense of impending diarrhea; get up; and faint in the bathroom. We report on a patient with recurrent sleep syncope (with physical injury) in whom an asystolic pause was documented during one of her “sleep syncope” spells. Implantation of a dual chamber pacemaker (5‐year follow‐up) “cured” her of further syncope. This is a report of pacemaker use for this unusual form of reflex syncope. (PACE 2012;xx; e1–e4)