Arrhythmias & electrophysiology
Coexistance of Carotid Sinus Hypersensitivity and Orthostatic Hypotension in Patients with Unexplained Syncope
- Study of patients with unexplained syncope undergoing carotid sinus massage and head-up tilt testing
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.
Read the original article ↗Cite NBIB · RIS · BibTeX
Summarised from the published abstract; every number is checked against it