Factors facilitating and hindering the implementation of the European Society of Cardiology Syncope Guidelines at the Emergency Department: A nationwide qualitative study

•We evaluated the implementation process of ESC syncope guidelines and identified 31 barriers and 22 facilitators.•Most barriers concerned the individual health care professionaland the organizational context.•Most facilitators were reported at the level of innovation.•The multidisciplinary Syncope Unit was welcomed as useful solution to a perceived need in clinical practice.•These barriers and facilitators should be used to designtailored interventions to impphese