Tags

Type your tag names separated by a space and hit enter

Reconsidering the effectiveness and safety of carotid sinus massage as a therapeutic intervention in patients with supraventricular tachycardia.
Am J Emerg Med. 2015 Jun; 33(6):807-9.AJ

Abstract

OBJECTIVE

The objectives of our investigation were to review the evidence for the efficacy and safety of carotid sinus massage in terminating supraventricular tachycardia and to determine if other potentially less harmful interventions have been established to be safer and more effective.

METHODS

A search using PubMed, Ovid, and COCHRANE databases was performed using the terms supraventricular tachycardia, carotid sinus massage, SVT, and CSM. Articles not written in English were excluded. There was a paucity of randomized controlled trials comparing various supraventricular tachycardia (SVT) interventions. However, articles of highest quality were selected for review and inclusion. In addition, articles examining potential hazards of carotid sinus massage in case report format were reviewed, even when performed for other indications other than SVT, as the maneuver is identically performed. Selected articles were reviewed by both authors for relevance to the topic.

RESULTS

Summarizing the findings of this review leads to these 3 fundamental conclusions. First, a therapeutic intervention should only be performed when the benefit of the procedure outweighs its risk. Carotid sinus massage exposes the patient to rare but potentially devastating iatrogenic harm. Second, a therapeutic intervention should be efficacious. The efficacy of carotid sinus massage in terminating supraventricular tachycardia appears to be modest at best. Third, other readily available, easily mastered, and potentially safer and more efficacious alternative interventions are available such as Valsalva maneuver and pharmacologic therapy.

CONCLUSION

Based on the limited evidence available, we believe that carotid sinus massage should be reconsidered as a first-line therapeutic intervention in the termination of SVT.

Authors+Show Affiliations

Maine Medical Center, 47 Bramhall St, Portland, ME 04102. Electronic address: collin1@mmc.org.Maine Medical Center, 47 Bramhall St, Portland, ME 04102. Electronic address: higgig@mmc.org.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25907500

Citation

Collins, Nikolas A., and George L. Higgins. "Reconsidering the Effectiveness and Safety of Carotid Sinus Massage as a Therapeutic Intervention in Patients With Supraventricular Tachycardia." The American Journal of Emergency Medicine, vol. 33, no. 6, 2015, pp. 807-9.
Collins NA, Higgins GL. Reconsidering the effectiveness and safety of carotid sinus massage as a therapeutic intervention in patients with supraventricular tachycardia. Am J Emerg Med. 2015;33(6):807-9.
Collins, N. A., & Higgins, G. L. (2015). Reconsidering the effectiveness and safety of carotid sinus massage as a therapeutic intervention in patients with supraventricular tachycardia. The American Journal of Emergency Medicine, 33(6), 807-9. https://doi.org/10.1016/j.ajem.2015.02.047
Collins NA, Higgins GL. Reconsidering the Effectiveness and Safety of Carotid Sinus Massage as a Therapeutic Intervention in Patients With Supraventricular Tachycardia. Am J Emerg Med. 2015;33(6):807-9. PubMed PMID: 25907500.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reconsidering the effectiveness and safety of carotid sinus massage as a therapeutic intervention in patients with supraventricular tachycardia. AU - Collins,Nikolas A, AU - Higgins,George L,3rd Y1 - 2015/03/07/ PY - 2015/01/29/received PY - 2015/02/25/revised PY - 2015/02/28/accepted PY - 2015/4/25/entrez PY - 2015/4/25/pubmed PY - 2015/10/1/medline SP - 807 EP - 9 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 33 IS - 6 N2 - OBJECTIVE: The objectives of our investigation were to review the evidence for the efficacy and safety of carotid sinus massage in terminating supraventricular tachycardia and to determine if other potentially less harmful interventions have been established to be safer and more effective. METHODS: A search using PubMed, Ovid, and COCHRANE databases was performed using the terms supraventricular tachycardia, carotid sinus massage, SVT, and CSM. Articles not written in English were excluded. There was a paucity of randomized controlled trials comparing various supraventricular tachycardia (SVT) interventions. However, articles of highest quality were selected for review and inclusion. In addition, articles examining potential hazards of carotid sinus massage in case report format were reviewed, even when performed for other indications other than SVT, as the maneuver is identically performed. Selected articles were reviewed by both authors for relevance to the topic. RESULTS: Summarizing the findings of this review leads to these 3 fundamental conclusions. First, a therapeutic intervention should only be performed when the benefit of the procedure outweighs its risk. Carotid sinus massage exposes the patient to rare but potentially devastating iatrogenic harm. Second, a therapeutic intervention should be efficacious. The efficacy of carotid sinus massage in terminating supraventricular tachycardia appears to be modest at best. Third, other readily available, easily mastered, and potentially safer and more efficacious alternative interventions are available such as Valsalva maneuver and pharmacologic therapy. CONCLUSION: Based on the limited evidence available, we believe that carotid sinus massage should be reconsidered as a first-line therapeutic intervention in the termination of SVT. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/25907500/Reconsidering_the_effectiveness_and_safety_of_carotid_sinus_massage_as_a_therapeutic_intervention_in_patients_with_supraventricular_tachycardia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(15)00137-0 DB - PRIME DP - Unbound Medicine ER -