Quality of life is deteriorated substantially by recurrent vasovagal syncope (VVS). Non-pharmacologic treatment is useful in all patients due to its simplicity and absence of side effects. Pharmacotherapy is aimed for patients with frequent episodes and short or absent prodromal phase which leads to inability to prevent loss of consciousness by immediate horisontalisation. Results of pharmacotherapeutic studies are not uniform and only few studies are placebo controlled. Randomised studies of dual chamber permanent pacing VPS I and VASIS demonstrated favourable results. These results were not confirmed by placebo controlled studies VPS II and SYNPACE. Cardiac pacing remains reserved for rare situation of cardioinhibitory VVS resistent to pharmacologic treatment.