The use of serotonin reuptake inhibitors for the treatment of recurrent syncope due to carotid sinus hypersensitivity unresponsive to dual chamber cardiac pacing.

Carotid sinus hypersensitivity can be a cause of recurrent unexplained syncope in the older patient. Dual chamber cardiac pacing may relieve the bradycardia, but may not affect the vasodilatory component of this disorder. We report on two patients with carotid sinus hypersensitivity with a predominant vasodilatory component who experienced recurrent syncope following permanent pacemaker implantation. Both patients were treated with serotonin reuptake inhibitors and after 4-6 weeks of therapy had complete resolution of symptoms. We conclude that serotonin reuptake inhibitors may be useful in the treatment of recurrent syncope due to carotid sinus hypersensitivity resistant to dual chamber cardiac pacing.