TY - JOUR T1 - Prolonged asystole induced by head up tilt test. Report of four cases and brief review of the prognostic significance and medical management. JF - Heart JO - Heart SP - 273 LP - 275 DO - 10.1136/hrt.77.3.273 VL - 77 IS - 3 AU - D. Pentousis AU - J. P. Cooper AU - S. M. Cobbe Y1 - 1997/03/01 UR - http://heart.bmj.com/content/77/3/273.abstract N2 - Head up tilt is an established test for assessing patients with vasovagal syncope. Prolonged asystole during the test has previously been reported in patients suffering from the malignant form of this syndrome. Little is known about the prognostic significance of this response and there is no consensus about the optimum treatment. Four such patients are reported who were treated pharmacologically. During follow up they remained free from major events and their symptoms were well controlled. Conservative management is the initial method of choice and only if this fails should implantation of a dual chamber permanent pacemaker be considered. ER -