CAROTID-SINUS HYPERSENSITIVITY IN PATIENTS WITH SYNCOPE - CLINICAL-DIAGNOSIS, THERAPY, AND FOLLOW-UP

The aim of this study was to assess the incidence and clinical characteristics of carotid sinus hypersensitivity in a group of subjects suffering from syncope. The total number of patients was 118. Twenty-four (20%) were diagnosed as epileptics (first attack) and 38 (32%) were vasodepressive. Fifty-six patients with unexplained syncope underwent carotid sinus massage during electrocardiographic registration and pressure monitoring. Forty-one patients were found to have carotid sinus hypersensitivity. Thirty-four of the 41 patients received implanatation of a pacemaker. Abnormal sinus node function was noted in 30 patients, abnormal atrioventricular (AV) node function in three, and combined abnormal sinus node and AV node function in one. Furthermore, three other patients who were negative to massage were implanted with a pacemaker because they had organic heart disease and recurrent syncope. Using different tests, such as 24-hour electrocardiographic monitoring and electrophysiologic study, we did not obtain better results in the diagnosis of syncope. Our data demonstrates the diagnostic importance of carotid sinus massage in the diagnosis of syncope. The validity of this method was confirmed in the 24-month follow-up.