Question: Do all patients who faint need a pacemaker?
Answer :The majority of patients who have fainting episodes do not need pacemakers. That said, we need to make a distinction between the common faint or vasovagal reflex which tends to occur in young people without any heart problems. Those forms of fainting which are by far the most common when we count the total number of fainting episodes in the population do not generally need pacemakers, although occasional patients in those categories will need pacemakers. Those are treated with medical treatment and with fluid replacement and other therapies.
For patients who are fainting because their heart rate is slow due to disease in the electrical system of the heart, they very definitely do need pacemakers to support the heart rate. The biggest danger with fainting in that condition is not so much dying as a result of the mechanism of the fainting, but rather injuring oneself or others if you're driving a car.
So for people with structural heart disease, with abnormalities in the electrical system of the heart that are fainting because of that, yes they do need pacemakers. For people with common faints due to an exaggerated normal reflex, generally younger people, for the most part, they do not need pacemakers.