A Synopsis: Neurocardiogenic Syncope, An International Symposium, 1996

Neurally mediated or neurocardiogenic syncopai syndromes,^ especially vasovagal syncope and carotid sinus syndrome (CSS), amount for the largest proportion of faints encountered in clinical practice. Nonetheless, despite such prominence, our understanding of the pathophysiological hasis for these forms of syncope remains limited,̂ "* and the optimal strategies for diagnosis and treatment of these conditions continue to be a source of dehate. This international symposium, the proceedings of which are reflected in this PACE supplement, brought together engineers, physicians, and physiologists recognized for their interest in and ongoing contributions to the understanding of neurally mediated (neurocardiogenic) syncope and its management. The principal goals were to address current understanding of those aspects of circulatory control that contribute to neurally mediated faints, review the current status of diagnostic and treatment strategies, and provide direction for the next investigational steps. A particular focus of interest was the potential for implantable devices to play a role in the management of neurally mediated syncope in the most severely affected patients. As is often the case in symposia of this type, many valuable contributions and insights occurred unexpectedly during poster presentations and discussion periods. Thanks to the efforts of several diligent note-takers, many of these ideas and criticisms were documented. In this synopsis. we attempt to summarize certain key elements of the symposium, incorporating where possible additional spontaneous comments provided by members of the expert audience.