Arrhythmias & electrophysiology
Coexistance of Carotid Sinus Hypersensitivity and Orthostatic Hypotension in Patients with Unexplained Syncope
Authors' conclusion
CSH and OH frequently coexist in adults over 40 years evaluated for syncope. CSM may reveal a clinically relevant cardioinhibitory reflex in a subgroup of OH patients, supporting comprehensive cardiovascular autonomic testing in unexplained syncope.
Study context
- Population
- Patients aged ≥40 years with unexplained syncopeage, 63.7 ± 13.0 years, men, 45.3%
- Participants
- 1,908 patients
- Comparison
- Occurrence of carotid sinus hypersensitivity (CSH) in classical and delayed orthostatic hypotension (OH), including asystolic carotid sinus massage (CSM) responses
- OHn = 618
Main finding
As reported in the abstract
Prevalence of OH and CSH
OH
618 patients
32.4%, 68.9 ± 11.3 years
CSH
320 patients
16.8%, 72.2 ± 9.9 years
Further findings
CSH · more common in patients with OH
P < 0.001
Asystolic CSM response · observed more often in OH patients
P < 0.001
- CSH in classical vs delayed OH: classical OH 22.5%
- CSH in classical vs delayed OH: delayed OH 25.2%
OH among patients with CSH
- Among patients with CSH, also had OH
- 46.6%
CSH in classical vs delayed OH
- CSH occurred equally in both classical and delayed OH
Factors associated with CSH among OH patients
- Among OH patients, CSH was associated with older age, male sex, lower supine diastolic blood pressure, hypertension, and syncope-related hospital admission
Asystolic CSM response
- Associated with older age and lower resting heart rate
Original publication
Coexistance of Carotid Sinus Hypersensitivity and Orthostatic Hypotension in Patients with Unexplained Syncope. Europace. Published 16 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it