Diagnostic utility of carotid sinus massage in patients with unexplained syncope

Mehta, A.; Mantri, R.R.; Sawhney, J.P.S.; Passey, R.; Dhawan, S.; Chopra, V.K. and Channa, P.K.K. (2002) Diagnostic utility of carotid sinus massage in patients with unexplained syncope. Supplement to the Journal of the American College of Cardiology, 39 (9). 27B.

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Abstract

The purpose of the present study was to evaluate the diagnostic utility of mechanical stimulation of carotid sinus in a series of patients with unexplained syncope. We analysed the data and found out that 106 patients were implanted permanent pacemaker for syncope from Jan 2000 to June 2001. On studying these records we found that there were 18 (16.9%) patients who were diagnosed to have carotid sinus hypersensitivity (CSH) and were implanted permanent pacemakers. We analysed the records of all the patients who were implanted pacemakers for CSH. Out of these 18 patients, there were 14 patients who were diagnosed to have unexplained syncope. These patients were later diagnosed to have CSH after all other investigations did not give us any clue for the cause of syncope. Out of these 6 patients had normal coronary angiograms i and 4 patients had normal EPS study. Head Up tilt test was also negative in all these patients. These patients were treated with permanent pacemaker implant. These patients have been followed for 10+9 months and all of them patients have not experienced any syncope. There observations suggest that there is a significant incidence of carotid sinus hypersensitivity (16.9%) in patients presenting with syncope. The incidence of CSH is specific ally high among the patients with unexplained syncope.

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