A pacing and sensing algorithm (800) which uses respiratory input to detect impending neurocardiogenic syncope is described. This algorithm (800), when used with conventional pacemakers, may be utilized to prevent recurrent syncope in patients with isolated recurrent neurocardiogenic syncope, as well in patients with established indications for pacemakers (e.g., conduction system disease, sudden cardiac death prophylaxis, cardiac resynchronization) and concurrent neurocardiogenic syncope.