ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2026
Determinants of carotid sinus hypersensitivity in patients with suspected reflex syncope.
Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- 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
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4 authors.
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Abstract
purposeTo elucidate the pathophysiology of the carotid sinus reflex in a large cohort of patients with suspected reflex syncope.
methodWe reviewed an electronic database of patients with suspected reflex syncope who underwent carotid sinus massage. The diagnostic protocol included both right and left massage, in supine and upright positions, followed by tilt testing.
resultsThe cohort included 2249 patients (52% male), median age 73 years. The conventional abnormality threshold of a maximum RR interval ≥ 3000 ms was present in 14.7% of patients and of a systolic blood pressure fall > 50 mmHg in 14.3% of patients. Abnormal responses occurred more frequently on the right side than the left side, and more during upright than supine testing. A second abnormal test occurred more often ipsilaterally. The extent of the maximum RR interval elicited by massage was independent of the baseline RR interval, whereas the difference in systolic blood pressure fall increased markedly with higher baseline values. The occurrence and severity of cardioinhibition and vasodepression increased with age, beginning at 40 years. Abnormal RR intervals and blood pressure drops were observed more frequently in men than in women. Additionally, there was only a limited correlation between positive responses to carotid massage and tilt testing concerning asystole and blood pressure reduction.
conclusionAge, sex and initial systolic blood pressure strongly influence response to carotid sinus massage. Abnormal responses did not correlate with positive tilt test results, possibly as a result of opposing effects of age and sex on carotid sinus hypersensitivity and vasovagal syncope.
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