Reproducibility of carotid sinus massage.
carotid sinus hypersensitivity
carotid sinus massage
carotid sinus syndrome
syncope
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
15
04
2020
accepted:
27
04
2020
pubmed:
5
5
2020
medline:
12
10
2021
entrez:
5
5
2020
Statut:
ppublish
Résumé
The reproducibility of carotid sinus massage (CSM) is debated. The aim of this study was to assess the reproducibility according to the methodology and diagnostic criteria defined by the guidelines on syncope of the European Society of Cardiology. Among 2800 patients with syncope who underwent CSM in the years 2005-2019, 109 patients (62 males; mean age 76 ± 10 years) had performed a second CSM after a median of 28 months. Carotid sinus hypersensitivity (CSH) was diagnosed when CSM elicited a pause of >3 s and/or a fall in systolic blood pressure >50 mm Hg without reproduction of spontaneous symptoms. Carotid sinus syndrome (CSS) was established when spontaneous symptoms were reproduced in the presence of bradycardia and/or hypotension. The reproducibility of CSM was 78% for 18 CSS patients, 41% for 29 CSH patients, and 77% for 62 negative patients. The corresponding interrater agreement was good for CSS (kappa = 0.66), moderate for negative CSM (kappa = 0.42), and poor for CSH (kappa = 0.30). Combining CSH and negative tests, their reproducibility rose to 90% with kappa = 0.66. CSS but not CSH has a good reproducibility. About half of patients with CSH had a negative response at the second test, thus suggesting a great overlap between them.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1190-1193Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Brignole M, Menozzi C, Lolli G, Bottoni N, Gaggioli G. Long-term outcome of paced and nonpaced patients with severe carotid sinus syndrome. Am J Cardiol.1992;69:1039-1043.
Brignole M, Gigli G, Altomonte F, et al. Cardioinhibitory reflex provoked by stimulation of carotid sinus in normal subjects and those with cardiovascular disease. G Ital Cardiol. 1985;15:514-519.
Podzek A, Frohner K, Meisl F. Significance of carotid sinus massage in patients with cerebrovascular symptoms. Pacin Clin Electrophysiol. 1983;6. Abstract.
Morley CA, Perrins EJ, Sutton R. Is there a difference between carotid sinus syndrome and sick sinus syndrome? Eur J Cardiac Pacing Electrophysiol. 1991;1:62-70.
Nishizaki M, Arita M, Sakurada H, et al. Long term follow-up of the reproducibility of carotid sinus hypersensitivity in patients with carotid sinus syndrome. Jpn Circ J. 1995;59:33-39.
Richardson DA, Bexton R, Shaw FE, Steen N, Bond J, Kenny RA. How reproducible is the cardioinhibitory response to carotid sinus massage in fallers? Europace. 2002;4:361-364.
Brignole M, Moya A, de Lange F, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39:1883-1948.
Brignole M, Moya A, de Lange F, et al. Practical instructions for the 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39:e43-e80.
Brignole M, Menozzi C. Carotid sinus syndrome: diagnosis natural history and treatment. Eur J Cardiac Pacing Electrophysiol. 1992;4:247-254.
Kerr S, Pearce M, Brayne C, Davies R, Kenny RA. Carotid sinus hypersensitivity in asymptomatic older persons. Arch Intern Med. 2006;166:515-520.