Carotid Sinus Hypersensitivity in Patients Presenting with Syncope

Overview

Journal Br Heart J

Specialty Cardiology & Vascular Diseases

Date 1979 Nov 1

PMID 518783

Citations 10

Authors

A B Davies

M R Stephens

A G Davies

Affiliations

Soon will be listed here.

Abstract

In 23 patients (ages 44 to 81) presenting with syncope, vertigo, or transient amnesia, carotid sinus massage produced a significant bradycardia in association with symptoms. The 10 most severely symptomatic patients were studied electrophysiologically, including measurement of intracardiac conduction times and corrected sinus node recovery times, as well as with carotid sinus massage before and after atropine. The only detectable abnormality in five of this group was asystole produced by carotid sinus massage; the other five had, in addition, evidence of either sinuatrial disease or an intracardiac conduction defect. Cardiac pacing in these 10 patients completely abolished their symptoms. In a control group of 52 asymptomatic patients (ages 36 to 87), an abnormal response to carotid sinus massage was uncommon (2%).

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References

SIGLER L . THE CARDIOINHIBITORY CAROTID SINUS REFLEX. ITS IMPORTANCE AS A VAGOCARDIOSENSITIVITY TEST. Am J Cardiol. 1963; 12:175-83. DOI: 10.1016/0002-9149(63)90307-2. View

HEIDORN G, MCNAMARA A . Effect of carotid sinus stimulation on the electrocardiograms of clinically normal individuals. Circulation. 1956; 14(6):1104-13. DOI: 10.1161/01.cir.14.6.1104. View

Evans T, Callowhill E, Krikler D . Clinical value of tests of sino-atrial function. Pacing Clin Electrophysiol. 1978; 1(1):2-7. DOI: 10.1111/j.1540-8159.1978.tb03434.x. View

Scarpa W . The sick sinus syndrome. Am Heart J. 1976; 92(5):648-60. DOI: 10.1016/s0002-8703(76)80085-3. View

Walter P, Crawley I, DORNEY E . Carotid sinus hypersensitivity and syncope. Am J Cardiol. 1978; 42(3):396-403. DOI: 10.1016/0002-9149(78)90934-7. View

Narula O, Shantha N, Vasquez M, Towne W, LINHART J . A new method for measurement of sinoatrial conduction time. Circulation. 1978; 58(4):706-14. DOI: 10.1161/01.cir.58.4.706. View

Voss D, MAGNIN G . Demand pacing and carotid sinus syncope. Am Heart J. 1970; 79(4):544-7. DOI: 10.1016/0002-8703(70)90261-9. View

Narula O, SAMET P, Javier R . Significance of the sinus-node recovery time. Circulation. 1972; 45(1):140-58. DOI: 10.1161/01.cir.45.1.140. View

Gupta P, Lichstein E, Chadda K, Badui E . Appraisal of sinus nodal recovery time in patients with sick sinus syndrome. Am J Cardiol. 1974; 34(3):265-70. DOI: 10.1016/0002-9149(74)90025-3. View

10.

Strauss H, Saroff A, BIGGER Jr J, Giardina E . Premature atrial stimulation as a key to the understanding of sinoatrial conduction in man. Presentation of data and critical review of the literature. Circulation. 1973; 47(1):86-93. DOI: 10.1161/01.cir.47.1.86. View

11.

Peretz D, Gerein A, Miyagishima R . Permanent demand pacing for hypersensitive carotid sinus syndrome. Can Med Assoc J. 1973; 108(9):1131-4. PMC: 1941398. View

12.

Thormann J, Schwarz F . Vagal role and pacemaker indication in hypersensitive carotid sinus reflex. Eur J Cardiol. 1975; 3(1):47-51. View

13.

Abdon N, MALMCRONA R . High pacemaker implantation rate following "cardiogenic neurology". Acta Med Scand. 1975; 198(6):455-61. View

14.

BAHL O, FERGUSON T, Oliver G, Parker B . Treatment of carotid sinus syncope with demand pacemaker. Chest. 1971; 59(3):262-5. DOI: 10.1378/chest.59.3.262. View

15.

ROSENBAUM M . The hemiblocks: diagnostic criteria and clinical significance. Mod Concepts Cardiovasc Dis. 1970; 39(12):141-6. View

16.

Thomas J . Hyperactive carotid sinus reflex and carotid sinus syncope. Mayo Clin Proc. 1969; 44(2):127-39. View