Syncope after administration of epidural analgesia in an obstetric patient with a vagus nerve stimulator.

Vagus nerve stimulation (VNS) is an adjunctive therapy for medically refractory epilepsy and depression. Vagus nerve stimulation is generally well-tolerated, but cardiac arrhythmias or asystole are rare complications that have been reported. This case report describes an obstetric patient who received epidural analgesia and subsequently experienced two episodes of syncope synchronous with stimulation from her VNS device. These resolved after deactivating the device. This is the first report of a suspected arrhythmia during VNS in the setting of epidural analgesia.