Long-Term Mortality in Cardioinhibitory Carotid Sinus Hypersensitivity Patient Cohort

Arq Bras Cardiol. 2020 Feb;114(2):245-253. doi: 10.36660/abc.20190008.
[Article in English, Portuguese]

Abstract

Background: Cardioinhibitory carotid sinus hypersensitivity (CICSH) is defined as ventricular asystole ≥ 3 seconds in response to 5-10 seconds of carotid sinus massage (CSM). There is a common concern that a prolonged asystole episode could lead to death directly from bradycardia or as a consequence of serious trauma, brain injury or pause-dependent ventricular arrhythmias.

Objective: To describe total mortality, cardiovascular mortality and trauma-related mortality of a cohort of CICSH patients, and to compare those mortalities with those found in a non-CICSH patient cohort.

Methods: In 2006, 502 patients ≥ 50 years of age were submitted to CSM. Fifty-two patients (10,4%) were identified with CICSH. Survival of this cohort was compared with that of another cohort of 408 non-CICSH patients using Kaplan-Meier curves. Cox regression was used to examine the relation between CICSH and mortality. The level of statistical significance was set at 0.05.

Results: After a maximum follow-up of 11.6 years, 29 of the 52 CICSH patients (55.8%) were dead. Cardiovascular mortality, trauma-related mortality and the total mortality rate of this population were not statistically different from that found in 408 patients without CICSH. (Total mortality of CICSH patients 55.8% vs. 49,3% of non-CICSH patients; p: 0.38).

Conclusion: At the end of follow-up, the 52 CICSH patient cohort had total mortality, cardiovascular mortality and trauma-related mortality similar to that found in 408 patients without CICSH.

MeSH terms

  • Aged
  • Carotid Artery Diseases / mortality*
  • Carotid Artery Diseases / physiopathology*
  • Carotid Sinus / physiopathology*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart Arrest / mortality*
  • Heart Arrest / physiopathology*
  • Heart Injuries / mortality
  • Heart Injuries / physiopathology
  • Humans
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Statistics, Nonparametric
  • Syncope / mortality
  • Syncope / physiopathology