The combination of ephedrine and propranolol may offer a novel pharmacologic approach to managing the difficult-to-treat vasodepressor component of mixed carotid sinus hypersensitivity.
May offer a pharmacologic option for refractory vasodepressor carotid sinus hypersensitivity; leaves open need for controlled validation.
Three forms of carotid sinus hypersensitivity are recognized clinically (cardio-inhibitory, vasodepressor, and mixed). The cardio-inhibitory form has been managed successfully with pacemaker therapy. The vasodepressor element has been difficult to manage clinically whether in its pure form or in combination with the cardio-inhibitory type. We review the various pharmacologic methods previously reported and present our experience with a new pharmacologic alternative, which is the combined use of ephedrine and propranolol to induce unopposed alpha stimulation.
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Keating et al. (1985) studied this question.
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