Recurrent unexplained syncope and presyncope comprise approximately 1 - 6% of emergency room and approximately 1% of hospital admissions.^1,2 The estimated incidence of self-reported syncope is 6.2 per 1,000 person years in the Framingham study.³ The overall incidence is approximately 3 - 6% over 10 years, and in a select group of patients, the prevalence of syncope could reach almost 50%.⁴ A symptom-rhythm correlation is often difficult to obtain during spontaneous episodes because of the sporadic, infrequent and unpredictable nature of syncope.¹ A significant percentage of patients referred for Holter monitoring, tilt-table test and electrophysiology study have inconclusive results. In addition, many of these patients also have a negative neurological workup.