Clinicians should be aware that a wide QRS-complex tachycardia that responds to carotid sinus massage is not necessarily supraventricular in origin.
Wide QRS tachycardia responsive to carotid sinus massage may be ventricular; this case report leaves open digoxin's role in facilitating vagal termination.
Carotid sinus massage affects supraventricular arrhythmias primarily through vagotonic effects on the sinus and AV nodes, but vagal innervation of the ventricle also exists and has been shown to have functional significance. The case presented here illustrates an unusual example of a ventricular tachycardia that was repeatedly converted to normal sinus rhythm by carotid sinus massage following administration of digoxin. The clinician should be aware that a wide QRS-complex tachycardia that responds to carotid sinus massage is not necessarily supraventricular in origin.
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Albelda et al. (1979) studied this question.
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