Paroxysmal atrioventricular block induced during head-up tilt test.

A 71-year-old female with vasovagal near-syncope suffered from paroxysmal second-degree AV block during Holter monitoring. AV block was easily reproduced during head-up tilt test. She was successfully treated with a dual chamber pacemaker. This treatment is unusual and the role of cardiac pacing in patients with vasovagal symptoms is reviewed.