Carotid sinus syncope treated by pacing. Analysis of persistent symptoms and role of atrioventricular sequential pacing.

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…12,286 Macroreentry around the granulomas is the most common mechanism of VA in patients with cardiac sarcoidosis. 280,281 Other mechanisms include triggered activity and abnormal automaticity due to myocardial inflammation. 282 Unlike AV block, the results of immunosuppression in patients with VA are controversial.…”

Swallowing: Is It a Carotid Massage Equivalent Causing Syncope in Patients With Neck Masses?

“…Dual chamber cardiac pacing is beneficial in patients with carotid sinus hypersensitivity who have a cardioinhibitory response. 11 The medical treatment of the vasodepressor type remains highly unsatisfactory although there have been case reports of limited success with beta blockade either alone or in combination with ephedrine. 12 Surgical denervation of the carotid sinus has also been tried as an option.…”

Atrial Demand Pacing in Patients with Symptomatic Sick Sinus Syndrome.

“…Currently there is accumulating favorable evidence showing that the occurrence of advanced AV block is slow and limited to only a minority of patients, and progression to high degree AV block may be predicted by the presence of an advanced conduction abnormality in the AV node, prolonged H-V interval on EP study, complete bundle branch block or bifascicular block at the time of initial evaluation, and sick sinus due to carotid hypersensitivity syndrome. [8][9][10][11]19,[29][30][31][32][33][34][35] Though it is influenced by autonomic activity and could not afford an accurate estimation of future occurrences of AV block, the Wenchebach point remains widely used in the initial assessment of AV nodal function.8,11) The low incidence of AV conduction abnormality in our well-selected patients is probably due to our strict criteria in the pre-operative selection of AAI patients. Though prior studies reported a similar prognosis in those paced ventricularly compared to those nonpaced,36,37) the difference in morbidity and/ or mortality between atrialy paced and ventricularly paced populations is significant.…”