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Long-term outcome in symptomatic carotid sinus hypersensitivity
M Brignole1, D Oddone, S Cogorno
1Service of Cardiology, Hospital of Lavagna, Italy.
American Heart Journal
|March 1, 1992
Summary
Carotid sinus massage (CSH) can reproduce syncope symptoms. CSH patients showed similar survival rates to controls, with age, sex, ECG, and heart failure predicting mortality.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- Syncope is a common clinical problem, often with unclear etiology.
- Carotid sinus massage (CSH) can reproduce symptoms in some patients with unexplained syncope.
Purpose of the Study:
- To assess the clinical outcome and survival rates of patients with syncope reproduced by CSH.
- To identify predictors of mortality in CSH patients.
Main Methods:
- Prospective observation of 312 patients with CSH-reproducible syncope.
- Follow-up of 262 CSH patients and comparison with 55 matched control patients.
- Cox proportional hazards model used to identify mortality predictors.
Main Results:
- CSH patients had an overall mortality rate of 7.3 per 100 person-years.
- Survival rates at 7 years were 53% for CSH patients and 69% for controls.
- Age, abnormal ECG, and heart failure were independent predictors of mortality in CSH patients.
Conclusions:
- CSH is a useful diagnostic tool for syncope.
- Mortality in CSH patients is comparable to unexplained syncope and the general population.
- Clinical factors like age, ECG, and heart failure are crucial for prognosis in CSH patients.