Pop and drop.

A 70-year-old man presented to cardiology clinic with recurrent syncope associated with consumption of carbonated beverages. Ambulatory monitoring revealed multiple symptomatic ventricular pauses. A barium esophagram was unremarkable, and the patient underwent placement of a dual chamber pacemaker for deglutition syncope with resolution of symptoms. A challenge of carbonated beverage was given, resulting in bradycardia that initiated an appropriate pacing response. This case illustrates the need for a thorough history when defining the etiology of syncope.