New onset syncopal events following vagus nerve stimulator implantation might be key to preventing vagus nerve stimulation-induced symptomatic bradycardia — A case report and review

PURPOSE: To identify risk factors for VNS-associated arrhythmia. METHODS: A literature review identified 14 papers with 21 patients. We compared patients with VNS associated arrhythmia (arrhythmia group, n = 22) and patients without VNS associated arrhythmia (control group of our VNS implanted patients, n = 29). RESULTS: New onset syncopal events following VNS placement were seen in the arrhythmia group (p < 0.001). CONCLUSION: Even though arrhythmia could be symptomatic, most cases associated with syncope were treated as new-onset epileptic seizures with adjustment of anti-seizure drugs. To detect cardiac asystole during VNS treatment, clinicians should be alert to the possibility of new onset syncopal events that differ from habitual seizures.