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Abstract
Carotid sinus massage is a simple bedside maneuver that helps to clarify the type
and sometimes also the mechanism of different rhythm disturbances. The major indication
for carotid sinus massage is the diagnosis of tachyarrhythmias in which the atrial
activity is either absent or intermittently present. Carotid sinus massage is also
useful in some patients with normal heart rates; increased vagal tone may normalize
a bundle branch block or localize the site of type I second-degree atrioventricular
block and can be used for evaluation of the sensing function of permanent pacemakers.
Carotid sinus massage is also an important diagnostic procedure in patients with suspected
hypersensitivity of the carotid sinus. Massage of the carotid sinus is contraindicated
in patients with diseased carotid arteries because of the risk of cerebrovascular
accident. In rare instances, carotid sinus massage may initiate ventricular tachycardia.