Complications related to carotid sinus massage in 502 ambulatory patients.

BACKGROUND

The carotid sinus massage (CSM) is a simple and low-cost technique with many indications.

OBJECTIVE

To determine the safety of CSM in outpatients with high prevalence of atherosclerotic disease and cardiopathy.

METHODS

A transversal study.

INCLUSION CRITERIA: Outpatients aged >or= 50 years, referred for ECG.

EXCLUSION CRITERIA: Individuals that refused to participate in a study on the prevalence of the cardioinhibitory response to CSM, patients with dementia, patients with pacemakers, individuals with carotid murmur or history of stroke or AMI in the last three months. The CSM was carried out in the supine position during 10 seconds. The occurrence of sustained arrhythmias or the occurence of neurological deficit during the CSM or in the first 24 hours after its end were considered complications of the CSM.

RESULTS

562 patients were randomly selected from a total of 1,686 individuals that met the inclusion criteria. Sixty individuals met the exclusion criteria. The remaining 502 patients (52% males, 69% with cardiopathies and 50% with atherosclerotic disease) were submitted to 1,053 CSM. Two patients presented complications (0.4%; 95%CI:0%-0.9%). A 71-yr-old man developed left arm monoparesis with complete regression within 30 minutes. Another 56-yr-old man presented left homonymous hemianopsia, with regression after 7 days.

CONCLUSION

The incidence of CSM-related complications was small, particularly when considering that the population submitted to the maneuver was elderly, with high incidence of structural heart disease and atherosclerotic disease.