ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Carotid sinus massage in clinical practice: the Six-Step-Method.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Management of Syncope in Geriatric Patients: Are 2018 European Society of Cardiology Guidelines Still Relevant?Journal of clinical medicine · 2026Review
- Indications, contraindications, and step-by-step methodology for performing carotid sinus massage in patients presenting with syncope : A scientific statement of an Ad Hoc Syncope Consortium endorsed by: the European Autonomic Society (EFAS), Gruppo Italiano Multidisciplinare Syncope (GIMSI) and European Geriatric Medicine Society (EuGMS).Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- Neurocardiology - from basics to clinic.World journal of cardiology · 2025Review
- A case report of sinus node-sparing hybrid ablation for refractory sinus tachycardia following cardioneuroablation for sinus node dysfunction.BMC cardiovascular disorders · 2025Article
- Pathophysiological aspects of carotid sinus massage.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Carotid sinus massage in clinical practice.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
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11 authors.
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Abstract
Carotid sinus massage (CSM) as integral part of cardiovascular autonomic testing is indicated in all patients > 40 years with syncope of unknown origin and suspected reflex mechanism. However, large practice variation exists in performing CSM that inevitably affects the positivity rate of the test and may result in an inaccurate diagnosis in patients with unexplained syncope. Even though CSM was introduced into medical practice more than 100 years ago, the method of performing CSM is still largely operator- and centre-dependent, while in many places, the test has been entirely abandoned. Here, we describe a standardized protocol on how to perform CSM, which basic monitoring equipment is necessary and why CSM is a safe procedure to perform. Our aim is to create a uniform approach to perform CSM. The new proposed algorithm, the Six-Step-Method, includes: (i) check history for exclusion CSM; (ii) turn head slightly contralaterally and posterior (see also explanatory video and poster provided as Supplementary material; (iii) palpation to identify carotid sinus location; (iv) massage for 10 s; (v) monitoring of blood pressure and heart rate to assess of the haemodynamic response type; and (vi) include time intervals between subsequent massages. Carotid sinus massage should be performed on both the left and right and in the supine and upright position. The recommended equipment to perform CSM consists of: (i) a tilt table in order to perform CSM in supine and standing position, (ii) a continuous blood pressure monitor or cardiac monitor, and (iii) at least two persons.
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