Hello Sir, My wife is 28-year-old, weight is 52 kg. She has had several episodes of syncope. She admitted to the hospital and underwent cardiac workup and diagnosed with sinus tachycardia. Her ECG and echocardiogram were normal, but in 24-hour Holter monitor, she was found to have maximum heart rate of 174 bpm and minimum of 61 bpm. There were few episodes of sinus arrest with atrial ectopies prolonged AV condution. Then, she was put on event recorder where she was found to have both bradycardia and tachycardia during episodes. Then, interventional cardiologist advised her for EP study and PPI. Then, we met electrophysiologist, by verifying all the reports, he advised her to do Tilt training exercises..She also undergone tilt table test, which came back as False Positive..We also met neuropsychologist, he put her on esecitalopram 20 mg at bed time and propranolol 20 mg. She was on escitalopram for 3 months, then discontinued. Now, she is taking propranolol 20 mg. Now episodes are less frequent, but she complains of chest pain and dyspnea on exertion, like bending forward, climbing up stairs or prolonged walking. Please help us. Regards, Sukanta Roy