Pause dependent ventricular tachycardia resultant from carotid sinus massage

Area of Science:

• Cardiology
• Electrophysiology
• Clinical Case Reports

Background:

• Carotid sinus massage (CSM) is a common diagnostic and therapeutic tool.
• It is frequently used to manage supraventricular tachycardias and assess syncope.
• CSM is generally considered a low-risk procedure in clinical practice.

Observation:

• A patient undergoing carotid sinus pressure experienced a transition from atrial flutter to ventricular fibrillation.
• This documented case highlights an unusual and severe complication of CSM.
• The event underscores the importance of monitoring during and after the procedure.

Findings:

• Atrial flutter can degenerate into ventricular fibrillation following carotid sinus pressure.
• This case demonstrates a rare but critical adverse event associated with a standard medical maneuver.
• The transition suggests a complex electrophysiological response to vagal stimulation.

Implications:

• Clinicians must be aware of the potential risks associated with carotid sinus massage.
• Continuous cardiac monitoring may be advisable during and after CSM, especially in patients with underlying cardiac conditions.
• This case emphasizes the need for cautious application and preparedness for adverse events during diagnostic procedures.