Further Observations on the Use of Pacemakers in Patients with Postural Orthostatic Tachycardia Syndrome with Demonstrated Asystole.

This study explores the use of pacemakers to treat syncope in a subgroup of patients with POTS who also exhibit neurocardiogenic syncope (NCS) and prolonged asystole. Among 500 patients reviewed, 40 had frequent syncope and were implanted with an implantable loop recorder (ILR), revealing prolonged asystole or severe bradycardia during episodes. Following dual-chamber pacemaker implantation, syncope was eliminated in all patients, although they still experienced orthostatic tachycardia. This suggests that while pacing can effectively address syncope in POTS patients with ILR-verified asystole, it does not affect orthostatic tachycardia.