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Results and complications of the carotid sinus massage performed according to the “method of symptoms”

      When the origin of syncope remains uncertain after the initial evaluation, carotid sinus massage (CSM) together with the tilt test becomes the method of choice to unmask neuromediated syncopes. In general, 2 different methods of performing CSM are used.
      • Brignole M.
      • Alboni P.
      • Benditt D.
      • Bergfeldt L.
      • Blanc J.J.
      • Bloch Thomsen P.E.
      • van Dijk J.G.
      • Fitzpatrick A.
      • Hohnloser S.
      • Janousek J.
      • et al.
      Guidelines on management (diagnosis, and treatment) of syncope. Task Force on Syncope, European Society of Cardiology.
      According to 1 method, the massage is performed only in the supine position, for a short time (usually 5 seconds), and the result is defined as positive if an asystole ≥3 seconds and/or a decrease in systolic blood pressure ≥50 mm Hg are induced The other method, the “method of symptoms,” involves performing CSM in both the supine and upright positions for 10 seconds; the test is defined as positive if, during the massage, the spontaneous symptoms are reproduced in association with cardioinhibition and/or vasodepression. This study describes results and complications in a large series of patients undergoing CSM according to the method of symptoms.
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