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Updated: Jun 24, 2026

Quantitative Autonomic Testing
Published on: July 19, 2011
Complications related to carotid sinus massage in 502 ambulatory patients
Gustavo de Castro Lacerda1, Roberto Coury Pedrosa, Renato Côrtes de Lacerda
1Hospital Geral de Bonsucesso, Ministério da Saúde, Rio de Janeiro, RJ, Brasil. glacerda@cardiol.br
Background:
The carotid sinus massage (CSM) is a simple and low-cost technique with many indications.
Objective:
To determine the safety of CSM in outpatients with high prevalence of atherosclerotic disease and cardiopathy.
Methods:
A transversal study.
Inclusion Criteria:
Outpatients aged >or= 50 years, referred for ECG.
Exclusion Criteria:
Individuals that refused to participate in a study on the prevalence of the cardioinhibitory response to CSM, patients with dementia, patients with pacemakers, individuals with carotid murmur or history of stroke or AMI in the last three months. The CSM was carried out in the supine position during 10 seconds. The occurrence of sustained arrhythmias or the occurence of neurological deficit during the CSM or in the first 24 hours after its end were considered complications of the CSM.
Results:
562 patients were randomly selected from a total of 1,686 individuals that met the inclusion criteria. Sixty individuals met the exclusion criteria. The remaining 502 patients (52% males, 69% with cardiopathies and 50% with atherosclerotic disease) were submitted to 1,053 CSM. Two patients presented complications (0.4%; 95%CI:0%-0.9%). A 71-yr-old man developed left arm monoparesis with complete regression within 30 minutes. Another 56-yr-old man presented left homonymous hemianopsia, with regression after 7 days.
Conclusion:
The incidence of CSM-related complications was small, particularly when considering that the population submitted to the maneuver was elderly, with high incidence of structural heart disease and atherosclerotic disease.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.