Reflex syncope: assessment and management

Evaluation of reflex syncope is often a difficult but fascinating task. It requires a physician to understand the physiological mechanisms of autonomic control of the cardiovascular system, knowledge of cardiac disorders which may lead to syncope and cooperation with other specialists, preferably as a team in a syncope unit. A diagnostic path is easier to carry out when it is done strictly according to the guidelines. New devices allowing for long-term ECG monitoring increase diagnostic yield. Treatment is still suboptimal but pacing in older patients is effective and cardioneuroablation in young is very promising. © 2023 BMJ Publishing Group. All rights reserved.