Key result
Cardiac pacing eliminates symptoms in ~100% of patients with severe carotid sinus hypersensitivity.
Case-Control (n=75)
Observes carotid sinus massage triggering symptomatic bradycardia resolved by cardiac pacing in syncope patients, indicating diagnostic and therapeutic efficacy.
In 23 patients (ages 44 to 81) presenting with syncope, vertigo, or transient amnesia, carotid sinus massage produced a significant bradycardia in association with symptoms. The 10 most severely symptomatic patients were studied electrophysiologically, including measurement of intracardiac conduction times and corrected sinus node recovery times, as well as with carotid sinus massage before and after atropine. The only detectable abnormality in five of this group was asystole produced by carotid sinus massage; the other five had, in addition, evidence of either sinuatrial disease or an intracardiac conduction defect. Cardiac pacing in these 10 patients completely abolished their symptoms. In a control group of 52 asymptomatic patients (ages 36 to 87), an abnormal response to carotid sinus massage was uncommon (2%).
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Davies et al. (1979) conducted a case-control in Syncope, vertigo, or transient amnesia with carotid sinus hypersensitivity (n=75). Carotid sinus massage and cardiac pacing vs. Asymptomatic control patients was evaluated on Abnormal response to carotid sinus massage / abolition of symptoms with cardiac pacing. Cardiac pacing abolished symptoms in 100% of 10 severely symptomatic carotid sinus hypersensitivity patients, while abnormal carotid sinus massage responses occurred in 2% of 52 asymptomatic controls.
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