Volume 114, Nº 2, February 2020

DOI: https://doi.org/10.36660/abc.20190008

ORIGINAL ARTICLE

Long-Term Mortality in Cardioinhibitory Carotid Sinus Hypersensitivity Patient Cohort

Figure 1 – Study design and results. CSM: Carotid sinus massage; CICSH: cardioinhibitory carotid sinus hypersensitivity.

Background: Cardioinhibitory carotid sinus hypersensitivity (CICSH) is defined as ventricular asystole ≥ 3 seconds in response to 5–10 seconds of carotid sinus massage (CSM). There is a common concern that a prolonged asystole episode could lead to death directly from bradycardia or as a consequence of serious trauma, brain injury or pause‑dependent ventricular arrhythmias.

Objective: To describe total mortality, cardiovascular mortality and trauma-related mortality of a cohort of CICSH patients, and to compare those mortalities with those found in a non-CICSH patient cohort.

Methods: In 2006, 502 patients ≥ 50 years of age were submitted to CSM. Fifty-two patients (10,4%) were identified with CICSH. Survival of this cohort was compared with that of another cohort of 408 non-CICSH patients using Kaplan-Meier curves. Cox regression was used to examine the relation between CICSH and mortality. The level of statistical significance was set at 0.05.

Results: After a maximum follow-up of 11.6 years, 29 of the 52 CICSH patients (55.8%) were dead. Cardiovascular mortality, trauma‑related mortality and the total mortality rate of this population were not statistically different from that found in 408 patients without CICSH. (Total mortality of CICSH patients 55.8% vs. 49,3% of non-CICSH patients; p: 0.38).

Conclusion: At the end of follow-up, the 52 CICSH patient cohort had total mortality, cardiovascular mortality and trauma-related mortality similar to that found in 408 patients without CICSH. (Arq Bras Cardiol. 2020; 114(2):245-253)

Keywords: Carotid Sinus,Massage/mortality; Bradycardia; Syncope; Cardiac Pacing, Artificial.