Arrhythmias & electrophysiology
Asymptomatic Asystolic Carotid Sinus Hypersensitivity Predicts Asystolic Events During Implantable Loop Recorder (ILR) Monitoring in Reflex Syncope Patients
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
Methodological detailspropensity score matched, historical control group
- Propensity score matched
- Historical control group
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.
Summarised from the published abstract; every number is checked against it