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[Carotid sinus massage is not a benign intervention].
Ned Tijdschr Geneeskd. 2017; 161:D1312.NT

Abstract

Carotid sinus massage for diagnosis and termination of supraventricular tachycardia (SVT) is still a widely used vagal manoeuvre in the A&E department. However, itsefficacy is limited (termination of the SVT in approximately 20%) and carotid sinus massage may be complicated by (potentially devastating) neurologic complications in 0.2-1% of the patients. There are safer interventions without neurologic complications, such as the modified Valsalva manoeuvre (efficacy 43%) and intravenous administration of adenosine (efficacy 75%). Monitor observation of the heart rhythm is required, both for vagal manoeuvres and for adenosine administration, because of the possibility of ventricular tachycardia or ventricular fibrillation induction (incidence 0.08%). Carotid sinus massage remains an important diagnostic method in patients with unexplained syncope in whom, based on the clinical history, carotid sinus hypersensitivity is suspected. It should be avoided in patients with previous TIA or stroke within the past 3 months, or those with carotid bruits, except if carotid Doppler studies have excluded significant stenosis (≥ 70%).

Authors+Show Affiliations

AMC, afd. Cardiologie, Amsterdam.No affiliation info available

Pub Type(s)

Journal Article

Language

dut

PubMed ID

28378703

Citation

van den Brink, R B A., and F J. de Lange. "[Carotid Sinus Massage Is Not a Benign Intervention]." Nederlands Tijdschrift Voor Geneeskunde, vol. 161, 2017, p. D1312.
van den Brink RB, de Lange FJ. [Carotid sinus massage is not a benign intervention]. Ned Tijdschr Geneeskd. 2017;161:D1312.
van den Brink, R. B., & de Lange, F. J. (2017). [Carotid sinus massage is not a benign intervention]. Nederlands Tijdschrift Voor Geneeskunde, 161, D1312.
van den Brink RB, de Lange FJ. [Carotid Sinus Massage Is Not a Benign Intervention]. Ned Tijdschr Geneeskd. 2017;161:D1312. PubMed PMID: 28378703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Carotid sinus massage is not a benign intervention]. AU - van den Brink,R B A, AU - de Lange,F J, PY - 2017/4/6/entrez PY - 2017/4/6/pubmed PY - 2018/7/28/medline SP - D1312 EP - D1312 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 161 N2 - Carotid sinus massage for diagnosis and termination of supraventricular tachycardia (SVT) is still a widely used vagal manoeuvre in the A&E department. However, itsefficacy is limited (termination of the SVT in approximately 20%) and carotid sinus massage may be complicated by (potentially devastating) neurologic complications in 0.2-1% of the patients. There are safer interventions without neurologic complications, such as the modified Valsalva manoeuvre (efficacy 43%) and intravenous administration of adenosine (efficacy 75%). Monitor observation of the heart rhythm is required, both for vagal manoeuvres and for adenosine administration, because of the possibility of ventricular tachycardia or ventricular fibrillation induction (incidence 0.08%). Carotid sinus massage remains an important diagnostic method in patients with unexplained syncope in whom, based on the clinical history, carotid sinus hypersensitivity is suspected. It should be avoided in patients with previous TIA or stroke within the past 3 months, or those with carotid bruits, except if carotid Doppler studies have excluded significant stenosis (≥ 70%). SN - 1876-8784 UR - https://www.unboundmedicine.com/medline/citation/28378703/[Carotid_sinus_massage_is_not_a_benign_intervention]_ L2 - http://www.ntvg.nl/D1312 DB - PRIME DP - Unbound Medicine ER -