Arrhythmias & electrophysiologyResearch article
Asymptomatic Asystolic Carotid Sinus Hypersensitivity Predicts Asystolic Events During Implantable Loop Recorder (ILR) Monitoring in Reflex Syncope Patients
- study
- propensity score matched
- historical control group
Authors' conclusion
Patients with asymptomatic asystolic CSH were more likely to experience spontaneous asystolic syncope than those without CSH. Among CSH patients who experienced a recurrence of syncope documented by an ILR, the positive predictive value of an asystolic pause detected during CSM was 76.3%.
Study context
- Population
- Reflex syncope patients with an asymptomatic pause >3 seconds during carotid sinus massage (CSM), implanted with an ILRCarotid sinus hypersensitivity (CSH) patients who received an ILR
- Participants
- 92 patients
- Comparison
- Asymptomatic asystolic CSH vs negative CSM
- CSH groupn = 92
Main finding
As reported in the abstract
Recurrence of syncope in CSH patients · median of 23.1 months
CSH group
41.3%
38 of 92
- asystole associated with recurrence, in 29 (76.3%) cases
- 8.0 seconds (95% CI: 5.3-13.5 seconds)
Further findings
| Outcome | HR | P value |
|---|---|---|
| Total syncope recurrence (actuarial rate) | 1.22 | P = 0.40 |
| Asystolic syncope | 2.13 | P = 0.011 |
| Asystolic pauses | 2.06 | P = 0.009 |
Original publication
Asymptomatic Asystolic Carotid Sinus Hypersensitivity Predicts Asystolic Events During ILR Monitoring in Reflex Syncope Patients. JACC Clin Electrophysiol. Published 29 January 2026. doi:10.1016/j.jacep.2025.12.028
Summarised from the published abstract; every number is checked against it