Indications, contraindications, and step-by-step methodology for performing carotid sinus massage in patients presenting with syncope
Clinical Autonomic Research, vol. 36, pp. 485–497
Abstract
Carotid sinus massage (CSM) is essential in evaluating recurrent unexplained reflex syncope, as it uniquely identifies cardioinhibitory forms that other tests may miss. CSM is largely underused in clinical practice outside dedicated syncope facilities and, when performed, its execution varies, as does the interpretation of results. Underuse affects the diagnostic yield of CSM in the syncope evaluation, thereby denying patients mechanism-based personalized treatment. There are several barriers to the proper use of CSM in the work-up of patients with unexplained syncope.To address these important limitations, an international panel of experts in the field of syncope provide herein a consensus document with the aim of offering practical guidance for the indications, contraindications, and methodology for performing carotid sinus massage in general and dedicated syncope facilities and in the emergency department.
Authors 30
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Frederik J. de Lange corresponding
Amsterdam Cardiovascular Sciences · University of Amsterdam
Affiliation as printed
Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. f.j.delange@amsterdamumc.nl
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IRCCS Istituto Auxologico Italiano
Affiliation as printed
Department of Cardiology Milan, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Affiliation as printed
Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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Affiliation as printed
Department of Bioengineering Cutrale Perioperative and Ageing Group, Imperial College London, London, W12 0BZ, UK
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Aix-Marseille Université · Assistance Publique Hôpitaux de Marseille · Hôpital de la Timone · Centre de Recherche en CardioVasculaire et Nutrition
Affiliation as printed
Aix Marseille Université, C2VN, 13005, Marseille, France
Assistance Publique, Hôpitaux de Marseille, Service de Cardiologie, Centre Hospitalier Universitaire La Timone, Marseille, France
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Innsbruck Medical University · Universität Innsbruck
Affiliation as printed
Department of Neurology, Medical University of Innsbruck, 6020, Innsbruck, Austria
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Karolinska University Hospital · Lund University · Karolinska Institutet
Affiliation as printed
Department of Cardiology, Karolinska University Hospital, Department of Medicine, Karolinska Institute, Stockholm, Sweden
Department of Clinical Sciences, Lund University, Malmö, Sweden
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IRCCS Istituto Auxologico Italiano
Affiliation as printed
Department of Cardiology Milan, IRCCS Istituto Auxologico Italiano, Milan, Italy
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University of Wisconsin–Madison
Affiliation as printed
Division of Cardiovascular Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
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Lund University · Skåne University Hospital
Affiliation as printed
Department of Cardiology, Skåne University Hospital, Malmö, Sweden
Department of Clinical Sciences, Lund University, Malmö, Sweden
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Amsterdam Cardiovascular Sciences · University of Amsterdam
Affiliation as printed
Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
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Trinity College Dublin · St. James's Hospital
Affiliation as printed
Trinity College and St James Hospital, Dublin, Ireland
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Affiliation as printed
Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, 04-073, Warsaw, Poland
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Affiliation as printed
Department of Cardiology, Hospital Universitari Dexeus, 08028, Barcelona, Spain
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Affiliation as printed
Department of Cardiology, Ospedali del Tigullio, Lavagna, Italy
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University of Calgary · Libin Cardiovascular Institute of Alberta
Affiliation as printed
Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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University of Iowa · University of Iowa Health Care
Affiliation as printed
Division of Cardiology, Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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University of Calgary · Libin Cardiovascular Institute of Alberta
Affiliation as printed
Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Trinity College Dublin · St. James's Hospital
Affiliation as printed
Trinity College and St James Hospital, Dublin, Ireland
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Azienda Ospedaliero-Universitaria Careggi · University of Florence
Affiliation as printed
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Division of Geriatric and Cardiogeriatric Medicine, Careggi University Hospital, Florence, Italy
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
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University of Campania "Luigi Vanvitelli" · Ospedale Monaldi
Affiliation as printed
Department of Translational Medical Sciences, Cardiology and Syncope Unit, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, Piazzale E. Ruggeri, 80126, Naples, Italy
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University of Calgary · Libin Cardiovascular Institute of Alberta
Affiliation as printed
Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Affiliation as printed
Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, USA
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Hammersmith Hospital · Imperial College London
Affiliation as printed
Department of Cardiology, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, London, UK
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Leiden University · Leiden University Medical Center · Stichting Epilepsie Instellingen Nederland
Affiliation as printed
Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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Imperial College Healthcare NHS Trust
Affiliation as printed
Imperial Syncope Unit, Imperial College Healthcare NHS Trust, London, W12 0HS, UK
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Affiliation as printed
Division of Cardiology, Ospedale Generale Regionale, Bolzano, Italy
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Azienda Ospedaliero-Universitaria Careggi · University of Florence
Affiliation as printed
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Division of Geriatric and Cardiogeriatric Medicine, Careggi University Hospital, Florence, Italy
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Affiliation as printed
Department of Cardiology, Reinier de Graaf Gasthuis, Delft, The Netherlands
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