1887
  1. الرئيسية
  2. A-Z Publications
  3. Global Cardiology Science and Practice
  4. المجلد 2014, العدد 2
  5. المقالة
Volume 2014, Issue 2
  • ISSN: 2305-7823
  • E-ISSN:

ملخص

Carotid sinus syndrome (CSS) is a disease of the autonomic nervous system presenting with syncope, especially in older males who often have cardiovascular disease. The aetiology is unknown and epidemiological data is limited. Forty new patients/million population have been estimated to require pacing for CSS and these patients represent ∼9% of those presenting syncope to a specialist facility. CSS is defined as a response to carotid sinus massage (CSM) that includes reproduction of spontaneous symptoms. Cardioinhibitory CSS shows 3s asystole on CSM and vasodepressor CSS shows >50 mmHg fall in blood pressure (BP), there are mixed forms. The methodology of CSM requires correct massage in the supine and upright with continuous ECG and BP. Assessment of the vasodepressor component implies the ‘method of symptoms’ using atropine to prevent asystole. Carotid sinus hypersensitivity (CSH) is a related condition where CSM is positive in an asymptomatic patient. CSH cannot be assumed to respond to pacing. CSS patients present syncope with little or no warning. If no cause is revealed by the initial evaluation, CSM should be considered in all patients >40 years. CSM carries a small risk of thromboembolism. Therapy for cardioinhibitory CSS is dual chamber pacing, which is most effective in patients with a negative tilt test. Syncope recurrence is ∼20% in 5 years in paced patients. Therapy for the vasodepressor component of CSS, as pure vasodepression or mixed, where tilt testing will likely be positive, is often unrewarding: alternative therapeutic measures may be needed including discontinuation/reduction of hypotensive drugs.

© 2014 Sutton, licensee Bloomsbury Qatar Foundation Journals.
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References

  1. Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt O-A, Cleland J, Deharo J-C, Delgado V, Elliott PM, Gorenek B, Israel CW, Leclercq C, Linde C, Mont L, Padeletti L, Sutton R, Vardas PE, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Kirchhof P, Blomstrom-Lundqvist C, Badano LP, Aliyev F, Bänsch D, Baumgartner H, Bsata W, Buser P, Charron P, Daubert J-C, Dobreanu D, Faerestrand S, Hasdai D, Hoes AW, Heuzey J-YL, Mavrakis H, McDonagh T, Merino JL, Nawar MM, Nielsen JC, Pieske B, Poposka L, Ruschitzka F, Tendera M, Gelder ICV, Wilson CM. ESC Guidelines on cardiac pacing and cardiac resynchronization therapy The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace 2013; 15:8:1070–1118. http://dx.doi.org/10.1093/europace/eut206 .
     [Google الباحث العلمي]
  2. Solari D, Maggi R, Oddone D, Solano A, Croci F, Donateo P, Brignole M. Clinical context and outcome of carotid sinus syndrome diagnosed by means of the “method of symptoms.”. Europace 2014; 16:6:928–934. http://dx.doi.org/10.1093/europace/eut283 .
     [Google الباحث العلمي]
  3. Moya A, Brignole M, Menozzi C, Garcia-Civera R, Tognarini S, Mont L, Botto G, Giada F, Cornacchia D. Mechanism of syncope in patients with isolated syncope and in patients with tilt-positive syncope. Circulation. 2001; 104:11:1261–1267. http://dx.doi.org/10.1161/hc3601.095708 .
     [Google الباحث العلمي]
  4. Healey J, Connolly SJ, Morillo CA. The management of patients with carotid sinus syndrome: is pacing the answer? Clin Auton Res. 2004; 14:1:i80–i86. http://dx.doi.org/10.1007/s10286-004-1012-2 .
     [Google الباحث العلمي]
  5. Miller VM, Kenny RA, Slade JY, Oakley AE, Kalaria RN. Medullary autonomic pathology in carotid sinus hypersensitivity. Neuropathol Appl Neurobiol. 2008; 34:4:403–411. http://dx.doi.org/10.1111/j.1365-2990.2007.00903.x .
     [Google الباحث العلمي]
  6. Brignole M, Menozzi C. Carotid sinus syndrome: diagnosis, natural history and treatment. Eur J Card Pacing Electrophysiol. 1992; 2::247–254.
     [Google الباحث العلمي]
  7. Tan MP, Newton JL, Chadwick TJ, Parry SW. The relationship between carotid sinus hypersensitivity, orthostatic hypotension, and vasovagal syncope: a case–control study. Europace. 2008; 10:12:1400–1405. http://dx.doi.org/10.1093/europace/eun278 .
     [Google الباحث العلمي]
  8. Roskam J. Un syndrome nouveau: syncopes cardiaques graves et syncopes répétées par hypereflexivité sinocarotidienne. Presse Med. 1930; 38::590–591.
     [Google الباحث العلمي]
  9. Weiss S, Baker J. The carotid sinus reflex in health and disease: its role in the causation of fainting and convulsions. Medicine. 1933; 12::293–354.
     [Google الباحث العلمي]
  10. Brignole M, Benditt DG. Reflex Syncope (Neurally Mediated Syncope). In Syncope: An evidence-based approach. London: Springer 2011;:164. Available at: http://link.springer.com/chapter/10.1007/978-0-85729-201-8_11 Accessed June 2, 2014.
     [Google الباحث العلمي]
  11. Brignole M, Menozzi C, Lolli G, Oddone D, Gianfranchi L, Bertulla A. Pacing for carotid sinus syndrome and sick sinus syndrome. Pacing Clin Electrophysiol. 1990; 13:12 Pt 2:2071–2075.
     [Google الباحث العلمي]
  12. Morley CA, Sutton R. Carotid sinus syncope. Int J Cardiol. 1984; 6:3:287–293. http://dx.doi.org/10.1016/0167-5273(84)90188-8 .
     [Google الباحث العلمي]
  13. Brignole M, Oddone D, Cogorno S, Menozzi C, Gianfranchi L, Bertulla A. Long-term outcome in symptomatic carotid sinus hypersensitivity. Am Heart J. 1992; 123:3:687–692. http://dx.doi.org/10.1016/0002-8703(92)90507-R .
     [Google الباحث العلمي]
  14. Thomas JE. Hyperactive carotid sinus reflex and carotid sinus syncope. Mayo Clin Proc. 1969; 44:2:127–139.
     [Google الباحث العلمي]
  15. Menozzi C, Brignole M, Lolli G, Bottoni N, Oddone D, Gianfranchi L, Gaggioli G. Follow-up of asystolic episodes in patients with cardioinhibitory, neurally mediated syncope and VVI pacemaker. Am J Cardiol. 1993; 72:15:1152–1155. http://dx.doi.org/10.1016/0002-9149(93)90985-L .
     [Google الباحث العلمي]
  16. Maggi R, Menozzi C, Brignole M, Podoleanu C, Iori M, Sutton R, Moya A, Giada F, Orazi S, Grovale N. Cardioinhibitory carotid sinus hypersensitivity predicts an asystolic mechanism of spontaneous neurally mediated syncope. Europace. 2007; 9:8:563–567. http://dx.doi.org/10.1093/europace/eum092 .
     [Google الباحث العلمي]
  17. Brignole M, Menozzi C, Gianfranchi L, Oddone D, Lolli G, Bertulla A. Carotid sinus massage, eyeball compression, and head-up tilt test in patients with syncope of uncertain origin and in healthy control subjects. Am Heart J. 1991; 122:6:1644–1651.
     [Google الباحث العلمي]
  18. Moya A, Sutton R, Ammirati F, Blanc J-J, Brignole M, Dahm JB, Deharo J-C, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Granell RR, Sarasin F, Ungar A, Dijk JG, van, Walma EP, Wieling W, Abe H, Benditt DG, Decker WW, Grubb BP, Kaufmann H, Morillo C, Olshansky B, Parry SW, Sheldon R, Shen WK, Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, McGregor K, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, Auricchio A, Acarturk E, Andreotti F, Asteggiano R, Bauersfeld U, Bellou A, Benetos A, Brandt J, Chung MK, Cortelli P, Costa AD, Extramiana F, Ferro J, Gorenek B, Hedman A, Hirsch R, Kaliska G, Kenny RA, Kjeldsen KP, Lampert R, Mølgard H, Paju R, Puodziukynas A, Raviele A, Roman P, Scherer M, Schondorf R, Sicari R, Vanbrabant P, Wolpert C, Zamorano JL. Guidelines for the diagnosis and management of syncope (version) The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Eur Heart J. 2009; 30:21:2631–2671. http://dx.doi.org/10.1093/eurheartj/ehp298 .
     [Google الباحث العلمي]
  19. Munro NC, McIntosh S, Lawson J, Morley CA, Sutton R, Kenny RA. Incidence of complications after carotid sinus massage in older patients with syncope. J Am Geriatr Soc. 1994; 42:12:1248–1251.
     [Google الباحث العلمي]
  20. Parry SW, Richardson DA, O'Shea D, Sen B, Kenny RA. Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential. Heart. 2000; 83:1:22–23. http://dx.doi.org/10.1136/heart.83.1.22 .
     [Google الباحث العلمي]
  21. Brignole M, Sartore B, Barra M, Menozzi C, Lolli G. Ventricular and dual chamber pacing for treatment of carotid sinus syndrome. Pacing Clin Electrophysiol. 1989; 12:4:582–590. http://dx.doi.org/10.1111/j.1540-8159.1989.tb02704.x .
     [Google الباحث العلمي]
  22. Dehn TCB, Morley CA, Sutton R. A scientific evaluation of the carotid sinus syndrome. Cardiovasc Res. 1984; 18:12:746–751. http://dx.doi.org/10.1093/cvr/18.12.746 .
     [Google الباحث العلمي]
  23. O'Dwyer C, Bennett K, Langan Y, Fan CW, Kenny RA. Amnesia for loss of consciousness is common in vasovagal syncope. Europace. 2011; 13:7:1040–1045. http://dx.doi.org/10.1093/europace/eur069 .
     [Google الباحث العلمي]
  24. Kenny RA, Richardson DA, Steen N, Bexton RS, Shaw FE, Bond J. Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE). J Am Coll Cardiol. 2001; 38:5:1491–1496. http://dx.doi.org/10.1016/S0735-1097(01)01537-6 .
     [Google الباحث العلمي]
  25. Ryan DJ, Nick S, Colette SM, Kenny RA. Carotid sinus syndrome, should we pace? A multicentre, randomised control trial (Safepace 2). Heart. 2010; 96:5:347–351. http://dx.doi.org/10.1136/hrt.2009.176206 .
     [Google الباحث العلمي]
  26. Crilley JG, Herd B, Khurana CS, Appleby CA, Belder MA, de, Davies A, Hall JA. Permanent cardiac pacing in elderly patients with recurrent falls, dizziness and syncope, and a hypersensitive cardioinhibitory reflex. Postgrad Med J. 1997; 73:861:415–418. http://dx.doi.org/10.1136/pgmj.73.861.415 .
     [Google الباحث العلمي]
  27. Parry SW, Steen N, Bexton RS, Tynan M, Kenny RA. Pacing in elderly recurrent fallers with carotid sinus hypersensitivity: a randomised, double-blind, placebo controlled crossover trial. Heart. 2009; 95:5:405–409. http://dx.doi.org/10.1136/hrt.2008.153189 .
     [Google الباحث العلمي]
  28. Voss DM, Magnin GE. Demand pacing and carotid sinus syncope. Am Heart J. 1970; 79:4:544–547. http://dx.doi.org/10.1016/0002-8703(70)90261-9 .
     [Google الباحث العلمي]
  29. Morley CA, Perrins EJ, Grant P, Chan SL, McBrien DJ, Sutton R. Carotid sinus syncope treated by pacing. Analysis of persistent symptoms and role of atrioventricular sequential pacing. Br Heart J. 1982; 47:5:411–418.
     [Google الباحث العلمي]
  30. Madigan NP, Flaker GC, Curtis JJ, Reid J, Mueller KJ, Murphy TJ. Carotid sinus hypersensitivity: beneficial effects of dual-chamber pacing. Am J Cardiol. 1984; 53:8:1034–1040. http://dx.doi.org/10.1016/0002-9149(84)90632-5 .
     [Google الباحث العلمي]
  31. Sutton R. Pacing in patients with carotid sinus and vasovagal syndromes. Pacing Clin Electrophysiol. 1989; 12:7:1260–1263. http://dx.doi.org/10.1111/j.1540-8159.1989.tb01982.x .
     [Google الباحث العلمي]
  32. Lopes R, Gonçalves A, Campos J, Frutuoso C, Silva A, Touguinha C, Freitas J, Maciel MJ. The role of pacemaker in hypersensitive carotid sinus syndrome. Europace. 2011; 13:4:572–575. http://dx.doi.org/10.1093/europace/euq455 .
     [Google الباحث العلمي]
  33. Brignole M, Menozzi C. The natural history of carotid sinus syncope and the effect of cardiac pacing. Europace. 2011; 13:4:462–464. http://dx.doi.org/10.1093/europace/euq516 .
     [Google الباحث العلمي]
  34. Chuen MJNK, Kirkfeldt RE, Andersen HR, Nielsen JC. Syncope in paced patients with sick sinus syndrome from the DANPACE trial: incidence, predictors and prognostic implication. Heart. 2014; 100:11:842–847. http://dx.doi.org/10.1136/heartjnl-2013-304976 .
     [Google الباحث العلمي]
  35. Brignole M, Menozzi C, Moya A, Andresen D, Blanc JJ, Krahn AD, Wieling W, Beiras X, Deharo JC, Russo V, Tomaino M, Sutton R. Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial. Circulation. 2012; 125:21:2566–2571. http://dx.doi.org/10.1161/CIRCULATIONAHA.111.082313 .
     [Google الباحث العلمي]
  36. Brignole M, Menozzi C, Lolli G, Bottoni N, Gaggioli G. Long-term outcome of paced and nonpaced patients with severe carotid sinus syndrome. Am J Cardiol. 1992; 69:12:1039–1043. http://dx.doi.org/10.1016/0002-9149(92)90860-2 .
     [Google الباحث العلمي]
  37. Claesson J-E, Kristensson B-E, Edvardsson N, Währborg P. Less syncope and milder symptoms in patients treated with pacing for induced cardioinhibitory carotid sinus syndrome: a randomized study. Europace. 2007; 9:10:932–936. http://dx.doi.org/10.1093/europace/eum180 .
     [Google الباحث العلمي]
  38. Gaggioli G, Brignole M, Menozzi C, Devoto G, Oddone D, Gianfranchi L, Gostoli E, Bottoni N, Lolli G. A positive response to head-up tilt testing predicts syncopal recurrence in carotid sinus syndrome patients with permanent pacemakers. Am J Cardiol. 1995; 76:10:720–722. http://dx.doi.org/10.1016/S0002-9149(99)80207-0 .
     [Google الباحث العلمي]
  39. Brignole M, Donateo P, Tomaino M, Massa R, Iori M, Beiras X, Moya A, Kus T, Deharo JC, Giuli S, Gentili A, Sutton R, International Study on Syncope of Uncertain Etiology 3 (ISSUE-3) Investigators . Benefit of pacemaker therapy in patients with presumed neurally mediated syncope and documented asystole is greater when tilt test is negative: an analysis from the third International Study on Syncope of Uncertain Etiology (ISSUE-3). Circ Arrhythm Electrophysiol. 2014; 7:1:10–16. http://dx.doi.org/10.1161/CIRCEP.113.001103 .
     [Google الباحث العلمي]
  40. Sutton R, Brignole M. Twenty-eight years of research permit reinterpretation of tilt-testing – hypotensive susceptibility rather than diagnosis. Eur Heart J. doi: 10.1093/eurheartj/ehu255. First published online: June 30, 2014.
     [Google الباحث العلمي]
  41. Romme JJ, Reitsma JB, Black CN, Colman N, Scholten RJ, Wieling W, Van Dijk N. Drugs and pacemakers for vasovagal, carotid sinus and situational syncope. In Cochrane Database of Systematic Reviews. John Wiley & Sons 1996;. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004194.pub3/abstract Accessed June 2, 2014.
     [Google الباحث العلمي]
  42. Ward CR, Gray JC, Gilroy JJ, Kenny RA. Midodrine: a role in the management of neurocardiogenic syncope. Heart. 1998; 79:1:45–49. http://dx.doi.org/10.1136/hrt.79.1.45 .
     [Google الباحث العلمي]
  43. American Society of Hypertension: Hypertension Guidelines. Available at: http://www.ash-us.org/About-Hypertension/Hypertension-Guidelines.aspx .
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Carotid sinus syndrome: Progress in understanding and management
Global Cardiology Science and Practice 2014, 18 (٢٠١٤); https://doi.org/10.5339/gcsp.2014.18
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  • نوع المستند: Review Article
الموضوعات الرئيسية cardioinhibition, carotid sinus hypersensitivity, carotid sinus massage, carotid sinus syndrome, falls, pacemaker, syncope and vasodepression
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