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ISRN Cardiology
Volume 2012 (2012), Article ID 216206, 5 pages
http://dx.doi.org/10.5402/2012/216206
Research Article

Recurrent Syncope in Patients with Carotid Sinus Hypersensitivity

1UO Emergency Medicine and Syncope Unit, Ospedale Santa Maria Nuova-Firenze, Piazza S. Maria Nuova, 1-50131, Florence, Italy
2Cardiology Unit, Electrophysiology and Syncope Unit, Ospedale Santa Maria Nuova-Firenze, Piazza S. Maria Nuova, 1-50131, Florence, Italy

Received 21 June 2012; Accepted 13 August 2012

Academic Editors: A. Bobik and R. Lazzara

Copyright © 2012 Alfonso Lagi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Syncope recurrence in pacemaker-implanted subjects for the cardio-inhibitory response to sinus carotid massage (SCM) was investigated. The study-hypothesis was that recurrences had significant vasodepressor responses that could justify the loss of consciousness. Forty-six patients were enrolled (16 patients and 30 controls), followed and revaluated after 5–7 years. At the end of follow-up, significant differences were found between patients and controls in mean SCM SAP (87 versus 106 mmHg) and reduction in mean SCM SAP (59 versus 38 mmHg); in the number of symptomatic subjects soon after SCM (5 versus 1); and in the number of subjects suffering from orthostatic hypotension. A subgroup of 13 patients showed significantly different hypotensive responses to SCM compared with the values observed at study recruitment. The data showed that some subjects with a defined hemodynamic pattern in response to SCM may change their characteristics and have spontaneous and/or provocative symptoms. These data explain the syncopal relapses, and suggest the presence of autonomic dysregulation in individuals with carotid sinus hypersensitivity.