Vasovagal reaction, resulting in bradycardia and/or hypotension in response to a number of
stimuli, is usually self-limiting, but potentially life-threatening exceptions have been described. Pharmacological
treatment of proven efficacy is still lacking and the administered compounds are often
chosen on the basis of either case reports or outdated small studies with a short-term follow up. In refractory
cases, pacemaker implantation may be considered, although no responder patients represent a
severe challenge for clinicians. The aim of this review is to examine the state of the art about this controversial
Keywords: Blood pressure, bradycardia, hyperactivity, reflex vagal hypertonia, sudden death, therapy.
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