Inclusion Criteria:

(A) ≥1 syncopal spells in the year preceding enrolment (B) ≥-2 points on the Calgary Syncope Symptom Score( Accurate Calculation for Diagnosis of Vasovagal Syncope) (C) Age ≥18 years with informed consent

Exclusion Criteria:

1. other causes of syncope, such as ventricular tachycardia, complete heart block, orthostatic hypotension or hypersensitive carotid sinus syndrome
2. an inability to give informed consent
3. important valvular, coronary, myocardial or conduction abnormality or significant arrhythmia
4. hypertrophic cardiomyopathy
5. a permanent pacemaker
6. a seizure disorder
7. hypertension defined as >160/90 mm Hg
8. pregnancy
9. lactating women
10. glaucoma
11. medications with known effects on BP
12. Known hypersensitivity to ondansetron and related medications
13. other factors which, in the investigator's opinion, would prevent the subject from completing the protocol.