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Related Experiment Videos

Carotid sinus hypersensitivity in patients presenting with syncope.

A B Davies, M R Stephens, A G Davies

    British Heart Journal
    |November 1, 1979
    PubMed
    Summary

    Carotid sinus massage can trigger symptoms like syncope in some individuals. Cardiac pacing effectively resolved these symptoms, indicating a link between heart rhythm and these neurological events.

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    Area of Science:

    • Cardiology
    • Neurology

    Background:

    • Carotid sinus hypersensitivity can cause syncope, vertigo, and transient amnesia.
    • Understanding the electrophysiological basis of these symptoms is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the role of carotid sinus massage in inducing symptoms.
    • To evaluate the effectiveness of cardiac pacing in patients with cardio-inhibitory syncope.

    Main Methods:

    • Carotid sinus massage performed on 23 patients with relevant symptoms.
    • Electrophysiological studies including intracardiac conduction times and corrected sinus node recovery times.
    • Carotid sinus massage before and after atropine administration in 10 severely symptomatic patients.
    • Cardiac pacing intervention in the symptomatic group.

    Main Results:

    • Significant bradycardia and symptoms were induced by carotid sinus massage in 23 patients.
    • Asystole or sinuatrial disease/conduction defects were identified in 10 severely symptomatic patients.
    • Cardiac pacing completely abolished symptoms in all 10 paced patients.
    • Abnormal responses to carotid sinus massage were rare (2%) in 52 asymptomatic controls.

    Conclusions:

    • Carotid sinus hypersensitivity, potentially with underlying sinoatrial or conduction defects, is a cause of syncope and related symptoms.
    • Cardiac pacing provides an effective treatment for drug-refractory cardio-inhibitory syncope related to carotid sinus stimulation.

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