[Carotid sinus syndrome diagnosed by transcutaneous cardiac pacing]

The diagnostic usefulness and safety of non-invasive heart stimulation has been tested on 20 persons with full symptomatic cardiodepressive type of carotid sinus syndrome. The estimation of the cardiodepressive syndrome has been conducted on the grounds of electrophysiological tests of the heart with the method of endocavitary stimulation introduced by Stryjer and adopted by us for non-invasive heart stimulation. Massage of the carotid sinus was performed during sinus rhythm, during transesophageal atrial stimulation and during transcutaneous ventricle stimulation. In 17 persons massage of the carotid sinus caused sinus node inhibition. In this group carotid sinus massage during atrial stimulation revealed a group of 10 persons with only sinus node inhibition (type A) and a group of 7 persons with the coexistence of sinus node inhibition and an AV III block (type C). Only in 3 persons massage of the carotid sinus merely caused an AV III block (type B). Massage of the carotid sinus during transcutaneous ventricle stimulation showed retrograde AV conduction suppression in type B and C of the carotid cardiodepressive syndrome. To recapitulate the obtained results, it can be assumed that electrophysiological estimation of the carotid sinus syndrome is also possible and safe with the non-invasive method. Such procedure can also facilitate the selection of patients for permanent stimulation of AAI type for the type A syndrome or DVV for types B and C.