| Title | [Cardioinhibitory carotid sinus hypersensitivity: prevalence and predictors in 502 outpatients.] | | Author(s) | Lacerda Gde C, Pedrosa RC, Lacerda RC, Santos MC, Perez Mde A, Teixeira AB, Siqueira-Filho AG | | Institution | Universidade Federal do Rio de Janeiro. | | Source | Arq Bras Cardiol 2008 Mar; 90(3):163-71. | | Abstract | BACKGROUND: Cardioinhibitory response (CIR) is defined as asystole >3 seconds in response to 5-10 seconds of carotid sinus massage (CSM). Pacemaker implantation is indicated for patients with unexplained syncope episodes and CIR.
OBJECTIVE: To determine the prevalence and predictors of CIR in patients with a high prevalence of cardiovascular disease, and assess the clinical significance of CIR in patients with a history of unexplained syncope or falls.
METHODS: Cross-section design study. Outpatients, aged >50 years, referred to the electrocardiography sector of a tertiary hospital. Those with dementia, carotid bruit, and history of myocardial infarction, stroke or transient ischemic attack in the preceding 3 months were excluded. CSM was performed by a single investigator, with the patients in the supine position. CSM was applied on the right side and then on the left side during 10 seconds each time.
RESULTS: 502 patients underwent CSM. CIR was present in 52 patients (10.4%; 95% CI: 7.7%-13%). Independent predictors of CIR were male gender (OR: 2.61%; CI 95%: 1.3%-5.1%), structural heart disease (OR: 3.28%; CI 95%: 1.3%-7.9%) and baseline heart rate (P<0.05). The sensitivity of the CIR to CSM in syncope evaluation was low (9.8%). Specificity was high (89.5%), being even better in women (95.3%) and in those without structural heart disease (96.2%).
CONCLUSION: CIR was detected in 10.4% of the patients aged > 50 years. In males and in patients with structural heart disease CIR was more common. In women and patients with no apparent structural heart disease, the presence of CIR was a highly specific finding in the evaluation of syncope or falls. | | Language | por | | Pub Type(s) | English Abstract
Journal Article
| | PubMed ID | 18392392 |
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