Prevalência e preditores da resposta cardioinibitória à massagem do seio carotídeo em 502 pacientes ambulatoriais

Abstract

SummaryBackground: 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.

A case of asystole from carotid sinus hypersensitivity during patient positioning for thyroidectomy

“…Since the sinus reflex is triggered by tension receptors, any loss of arterial distensibility with age and with atherosclerosis may reduce neural output of the afferent limb of the reflex loop. As a result the expected compensatory effect is baroreflex efferent hypersensitivity and enhancement of the reflex [ 14 – 16 ]. Our patient had long standing arterial hypertension and was current smoker, both known risk factors for atheroscleroris.…”

“…Study by Gustavo et al assessing 502 patients with a history of unexplained syncope or falls found that the use of negative chronotropic drugs are associated with a risk ratio 2.18 of developing cardioinhibitory response of carotid sinus hypersensitivity [ 16 ]. B blockers not only block sympathetic nervous system leaving unopposed the activity of vagus nerve but along with digitalis and methyldopa enhance the sensitivity of carotid sinus ( http://emedicine.medscape.com/article/153312 ).…”

Mortalidade de uma Coorte de Portadores da Resposta Cardioinibitória à Massagem do Seio Carotídeo – Estudo Longitudinal com 11 Anos de Seguimento

“…In 2006, in the first phase of the present study, 502 patients were randomly selected among 1,686 outpatients ≥50 years of age referred to electrocardiography in a public general hospital in Rio de Janeiro, Brazil. 8 These 502 patients were submitted to CSM, 52 (10,4%) were identified with CICSH (ventricular asystole ≥3) and, in 450, cardioinhibitory reflex was absent. In all cases, CSM was performed in the supine position, initially on the right side, then on the left side for 10 seconds by a single investigator.…”

Incidência de complicações relacionadas à massagem do seio carotídeo em 502 pacientes ambulatoriais

“…aimed at evaluating the prevalence and the predictors of the cardioinhibitory response to CSM 10 . This study was approved by the Ethics Committee in Research of the institution.…”

“…The cardioinhibitory response to the CSM was present in 52 patients (prevalence: 10.4%; 95%CI: 7.7%-13%). The characteristics of these 52 patients and the predictors of the cardioinhibitory response can be found in an article published in this same journal 10 .…”