He and his coinvestigators performed a meta-analysis of the three pre-2000 randomized controlled trials that compared the standard Valsalva maneuver to carotid sinus
massage plus the two newer studies, both of which systematically compared a modified Valsalva maneuver with the standard version.
He had a medical history of hypertension, dyslipidemia, carotid sinus
hypersensitivity status post dual chamber pacemaker implant (five years prior), and abdominal aorta aneurysm repair.
Another vagal maneuver, the carotid sinus
massage, is less commonly done and not favored due to invasiveness and the potential for injury to the carotid vessel.
The carotid sinus
is in the carotid artery, which takes blood from the heart to the brain.
Moreover, alteration of the carotid sinus
pressure resulting from neck palpation or electric stimulation may cause carotid baroreflex (Filippone & Bisognano, 2007).
massage could not be performed due to the significant probability of the existence of atherosclerotic plaques within the carotid arteries.
Among the neutrally mediated investigations, the tilt-test and carotid sinus
massage are the most useful.
Caption: FIGURE 3: Early arterial phase of the lateral carotid angiography with the filling of the carotid sinus
via the fistula ((a) white arrows) and lateral carotid angiogram with the fistula completely closed after transvenous coil embolization ((b) black arrow).
syndrome or autonomic dysfunction may occur when mass effect involves the carotid sinus
baroreceptor, airway, or recurrent laryngeal nerve .
Currently, we recommend removal of the catheter during catheter manipulation in patients undergoing radial coronary angiography to alleviate bradycardia when there is a suspicion of excessive stretching of aortic arch and/or carotid sinus
A likely explanation for the irregularity is that the P-P interval is prolonged by an increase in parasympathetic tone and a decrease in sympathetic tone resulting reflexly from stimulation of the carotid sinus
by systolic ejection.
She also presented carotid sinus
syndrome that was also extremely rare among CBT patients.