ABC | Volume 111, Nº1, July 2018

Original Article Wu et al Carotid sinus massage in syncope evaluation Arq Bras Cardiol. 2018; 111(1):84-91 In the asymptomatic group, 5 patients reported presyncope, 10 patients, dizziness, and 2 patients, nonspecific symptoms. Only 2 patients in the symptomatic group had syncope, which occurred with ventricular pauses of 8.2 and 8.1 seconds. Symptoms reported with normal or abnormal responses made up 17.8% of normal, 78% of CI, and 47.1% of VD Table 2 – Distribution of responses to carotid sinus massage by age, sex, and underlying diseases, such as hypertension, diabetes and coronary artery disease. Variable Response to CSM TOTAL p No CSH Cardioinhibitory Vasodepressor n % n % n % n Age 0.356 # 50–59 22 78.5 5 17.9 1 3.5 28 60–69 30 69.7 9 20.9 4 9.3 43 70–79 31 56.3 15 27.3 9 16.3 55 ≥ 80 24 61.5 12 30.8 3 7.6 39 Sex < 0.001* Male 30 46.1 28 43.1 6 9.2 65 Female 77 77.0 13 13.0 11 11.0 100 Hypertension 0.849 # - 25 65.7 10 26.3 3 7.8 38 + 82 64.5 31 24.4 14 11.0 127 Diabetes 0.095 # - 90 68.1 28 21.2 14 10.6 132 + 17 51.5 13 39.4 3 9.0 33 Coronary artery disease 0.401 # - 99 66.4 35 23.5 15 10.0 149 + 8 50.0 6 37.5 2 12.5 16 Total 103 62 41 25 21 13 165 CSM: carotid sinus massage; CSH: carotid sinus hypersensitivity; # likelihood ratio test; * chi-square test Figure 3 – Magnitudes of systolic blood pressure response (ΔSBP) (above) and heart rate response (ΔRR) (below) in the symptomatic and asymptomatic groups during carotid sinus massage. 80 70 60 50 40 30 20 10 0 –10 mmHg 74 75 p = 0.181 28.3 –4 –4 –1 3 64 31.7 p = 0.204 29.2 56 32 ∆SBP right (Symptomatic) ∆SBP right (Asymptomatic) ∆SBP left (Symptomatic) ∆SBP left (Asymptomatic) ∆SBP right (Symptomatic) ∆SBP right (Asymptomatic) ∆SBP left (Symptomatic) ∆SBP left (Asymptomatic) 5800 883 0 1159 36 0 1016 915 29 6466 7600 6934 p = 0.747 p = 0.174 Maximum Meam Minimum 8000 7000 6000 5000 4000 3000 2000 1000 0 ms responders. Likewise, many asymptomatic patients showed a positive response without related symptoms, especially VD response (82.2% of normal, 22% of CI, and 52.9% of VD). Symptoms resulting from the CSM occurred mainly when the SBP dropped below 90mmHg and/or the RR intervals extended longer than 2500 ms (Table 4). 87