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How reproducible is the cardioinhibitory response to carotid sinus massage in fallers?

Lookup NU author(s): Dr Rodney Bexton, Dr Fiona Shaw, Dr Nick Steen, Professor John Bond, Professor Rose Anne Kenny

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Abstract

Aims To ascertain the reproducibility of the cardio-inhibitory subtype of carotid sinus hypersensitivity (CICSH) in fallers. Methods and Results One hundred and seventy-five subjects with CICSH and unexplained or recurrent falls were randomized to pacemaker implantation or control. Sixty-four control subjects (61% female, mean age 71.8 years, median 2 falls in the previous year) completed one-year follow-up and had carotid sinus massage (CSM) performed on 4 occasions (twice before randomization, at 6 months and 1 year following randomization). CSM was performed sequentially on the right and then left sides, initially supine and then upright at 70° head-up tilt by the same investigator. On each occasion CSM was discontinued once CICSH was demonstrated. CICSH was demonstrated on 82% of occasions, 75% on right CSM and 77% whilst the subject was supine. Before randomization, and at 6 months and 1 year, 91%, 67%, and 70% of subjects had reproducible CICSH respectively. Half had CICSH on all 4 occasions. Only 17% had a consistent response on the same side in the same position. Conclusions In the majority of subjects CICSH is reproducible and this is more likely shortly after the initial response. However the cardioinhibitory response to CSM is inconsistent both in side elicited and subject position. © 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Publication metadata

Author(s): Richardson DA, Bexton R, Shaw FE, Steen N, Bond J, Kenny RA

Publication type: Article

Publication status: Published

Journal: Europace

Year: 2002

Volume: 4

Issue: 4

Pages: 361-364

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1053/eupc.2002.0264

DOI: 10.1053/eupc.2002.0264

PubMed id: 12408254

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