Incidence of Complications After Carotid Sinus Massage in Old er Patients with Syncope

Munro, Neil C.; Mclntosh, Shona; Lawson, Joanna; Morleyf, Chris A.; Sutton, Richard; Kenny, Rose Anne

doi:10.1111/j.1532-5415.1994.tb06505.x

Cited by 126Cardiovascular Syncope and Autonomic DisordersVestibular and auditory disordersCerebrovascular and Carotid Artery Diseases

Incidence of Complications After Carotid Sinus Massage in Old er Patients with Syncope

Munro, Neil C., Mclntosh, Shona, Lawson, Joanna, Morleyf, Chris A., Sutton, Richard, Kenny, Rose Anne·1994·Journal of the American Geriatrics Society

DOI 10.1111/j.1532-5415.1994.tb06505.x

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Abstract

OBJECTIVE: To review the incidence of neurological complications occurring after carotid sinus massage performed for diagnostic purposes. DESIGN: Case review and comparison with previously published work. SETTING: Syncope Clinic, Royal Victoria Infirmary, Newcastle-upon-Tyne, and Chelsea and Westminster Hospital, London. PARTICIPANTS: Patients undergoing investigation of dizziness, syncope, or unexplained falls. METHODS: Carotid sinus massage performed for 5 seconds in both supine and erect postures, both before and after atropine. Contraindications to carotid sinus massage were the presence of carotid bruits, recent myocardial or cerebral ischemia, or previous ventricular tachyarrhythmias. RESULTS: Two cases of neurological complications were reported from a total of 500 patients (2000 massage episodes) investigated in one center, giving an incidence of 0.1%. Combining this data with another center performing investigations in a similar fashion, seven neurological complications arose from a total of 5000 massage episodes, an incidence of 0.14%. Reported complications were pyramidal signs in five cases and visual field defects in two. Pyramidal weakness persisted in one case with a pre-existing stroke on the same side, and a visual field loss was permanent in one. CONCLUSIONS: Neurological complications following carotid sinus massage for diagnosis of the carotid sinus syndrome are uncommon and usually transient. Contraindications to carotid sinus massage should be respected and the standardized technique used.

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Crossref · 10.1111/j.1532-5415.1994.tb06505.x

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When pooling data from four studies in which 8720 patients were analysed, transient ischaemic attacks or strokes were observed in 21 patients (0.24%) after carotid sinus massage.
“When pooling the data from four studies 90,95-97 in which 8720 patients were analysed, TIAs or strokes were observed in 21 (0.24%).”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [95]

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Original Article Complications Related to Carotid Sinus Massage in 502 Ambulatory Patients
Lacerda, G. D. C., Pedrosa, R. C., de Lacerda, R. C., Dos, M. C., Brasil, A. T., & de Siqueira-Filho, A. G. (2008)

Authors: Munro, N. C., Mclntosh, S., Lawson, J., Morleyf, C. A., Sutton, R., & Kenny, R. A.
Affiliations: Royal Victoria Infirmary (GB)
St. Luke's Hospital (GB)
Chelsea and Westminster Hospital (GB)
Corresponding author: Kenny, Rose Anne
ORCID: Lawson, Joanna
Sutton, Richard
Kenny, Rose Anne
Venue: Journal of the American Geriatrics Society
Publisher: Wiley
Published: 1994-12
Volume: 42
Issue: 12
Pages: 1248-1251
ISSN: 0002-8614 (ISSN-L)
1532-5415
DOI: 10.1111/j.1532-5415.1994.tb06505.x
OpenAlex: W2159067126
Cited by: 126
References: 17
Citations by year: 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 5 · 2013: 3 · 2012: 2
FWCI: 3.35
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 7452 d)
Locations: Journal of the American Geriatrics Society (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
Keywords: carotid sinus massage, neurological complications, syncope, carotid sinus syndrome, elderly patients, pyramidal signs, visual field defects, atropine, dizziness, unexplained falls, complication incidence, contraindications
MeSH terms: Contraindications, Aged, Aged, 80 and over, Atropine, Carotid Sinus, Humans, Male, Massage, Nervous System Diseases, Syncope, Time Factors, Incidence, Supine Position

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Incidence of Complications After Carotid Sinus Massage in Old er Patients with Syncope

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