Carotid Sinus Massage to Detect Hypersensitivity

Carotid sinus massage may be a useful diagnostic in patients with unexplained syncope who are 50 or older, but not in younger patients.

Carotid sinus hypersensitivity (CSH) frequently accounts for unexplained falls and syncope in patients older than 65 (45% according to Kenny and colleagues; Age Ageing 2001; 30:289) but is rare before age 50 (Am J Cardiol 2002; 89:599).

Researchers retrospectively evaluated results of bilateral carotid sinus massage (CSM) in 373 patients with unexplained syncope, presyncope, or falls (age range, 15–92). CSM was applied with patients in supine position and again during 60° head-up tilt if supine CSM was unremarkable. CSH was classified as cardioinhibitory (asystole ≥3 sec), vasodepressor (systolic blood pressure fall ≥50 mm Hg), or mixed.

Fifty-one patients (13.7%) had CSH, 25 of them only during tilt. CSM was positive in none of 65 patients y…

Reviewing Author

Max J. Hilz, MD

Carotid Sinus Massage to Detect Hypersensitivity

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Reviewing Author