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January 2009 Br J Cardiol 2009;16:21–8

Emergence of the rapid access blackout clinic

Ibrahim Ali, Trudie Lobban, Richard Sutton, Alex Everitt, Darrel P Francis

Abstract

Introduction Case history 1 PL is a 19-year-old female who presented with two episodes of blackout accompanied with convulsions. She was diagnosed with epilepsy and prescribed carbamazepine. Episodes continued, however, and one year later she was further investigated by tilt-testing and discovered to have cardioinhibitory vasovagal syncope. A dual-chamber rate-drop-response pacemaker was implanted and no further episodes occurred during five years of follow-up. Anticonvulsant medication was stopped without ill effect. Case history 2 CM is a 72-year-old male admitted for pain control following an unwitnessed fall, which although initially bel

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