Summary

This article presents evidence from the International Study on Syncope of Uncertain Etiology 3 Study [ISSUE3; NCT00359203], demonstrating that cardiac pacing therapy is effective for prevention of recurrent syncope in patients with neurally mediated syncope (NMS) and documented asystole. These data contradict previous data from two randomized trials [Connolly SJ et al. JAMA 2003; Raviele A et al. Eur Heart J 2004] that failed to prove the superiority of cardiac pacing over placebo for the prevention of syncopal recurrences in unselected patients who were affected by NMS.