Syncope: Pacing or Recording in the Later Years

"A single or dual chamber pacemaker will be implanted according to the manufacturer's instructions for use with standard techniques.~Either a single or dual chamber pacemaker will be permitted according to local practice unless the patient is in chronic or persistent atrial fibrillation, in which case a single chamber pacemaker will be used. The pacemaker configuration will be at the discretion of the investigator.~Single chamber ventricular pacemakers will be programmed to activity responsiveness off in VVI mode, rates 50-120 bpm.~Dual chamber pacemaker programming will be to DDD mode (50-120) with mode switch on."

The implantable loop recorder will be programmed for automatic detection using settings of Low Heart Rate \<50 bpm, High Heart Rate \>165 bpm, and Pause \> 3 seconds.