EDITORIAL Different electrocardiographic manifestations of the cardioinhibitory vasovagal reflex

This editorial refers to ‘Electrocardiographic character-istics of atrioventricular block induced by tilt testing ’ by Dorota Zyśko et al., on page 225 Syncope is a transient symptom. Typically patients affected by vaso-vagal syncope (VVS) are asymptomatic at the time of evaluation, and the opportunity to capture a spontaneous event is rare. The increas-ing use, during the last two decades, of tilt testing and prolonged electrocardiographic (ECG) monitoring in the clinical practice, especially implantable loop recorder (ILR), has made easier the ECG documentation of an attack, thus increasing our knowledge on the mechanism of the cardioinhibitory vasovagal reflex. Very little has been reported in the literature on the ECG charac-teristics of vagally induced atrioventricular (AV) block. Atrioventri-cular block during tilt testing is a rare finding. The majority of previous reports described only few cases.1–4 Zyśko et al.5 repor