Presentation: A 53 year old woman presented with a syncopal episode which occurred whilst sitting in bed reading, witnessed by her husband. She was unrousable for maybe half a minute. She had no other medical history, clinical examination was unremarkable, as were multiple investigations. Diagnosis: A loop recorder was inserted without difficulty. A few weeks later she again blacked out. Her loop recorder showed asystole for 39 seconds, followed by a return to sinus bradycardia and then sinus

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... ythm, accompanied by recovery of consciousness. Treatment: She went on to have a dual chamber pacemaker inserted. At review after six weeks, six months and one year she had had no further syncopal episodes. Conclusion : This case reports one of the longest documented episodes of asystole with spontaneous recovery and serves as a reminder of the utility of internal loop recorders in the investigation of syncope. G. Pate (2020) Internal Loop Recording of Prolonged (39 Second) Sinus Pause Causing Syncope J Cardiol Clin Pract, Volume 3(1): 2-3, 2020 Figure 1. Internal loop recorder tracing of 39.4 second asystolic pause.