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To the Editor.
Woody and Kiel reported a child in whom syncopal episodes occurred while swallowing.1 They treated the child by implanting a permanent pacemaker. In the article, they referred to other possible treatments such as the use of atropine to block the, presumably, vagal reflux. Unfortunately, there was no mention made of a test of this hypothesis.
We reported a similar case in 19722 and were able to document blocking of the reflux with atropine.