Pacemaker Therapy as a New Possibility for the Diagnosis and Treatment of Carotid Sinus Syncope

The hypersensitivity of the carotid sinus reflex — carotid sinus hyperaesthesia — is not a rare clinical syndrome. In our patient material (1971–1974) we found 152 such cases. It is also known that Adams-Stokes attacks can often be provoked by the stimulation of the carotid sinus nerve. In the correct diagnosis and differential diagnosis of carotid sinus hyperaesthesia difficulties can sometimes occur. The electrical stimulation of the right atrium and ventricle before and during carotid sinus nerve stimulation provides a new possibility in the analysis of the arrhythmias and conduction disorders accompanying carotid sinus hyperaesthesia. Therapeutic intervention is urgently indicated in cases of hypersensitivity of the carotid sinus reflex, in which cardiac arrest — carotid sinus syncope — can be observed. Pacemaker implantation is a new and most effective procedure in the treatment of carotid sinus syncope. In the last two years we have regularly applied electrical stimulation of the heart in carotid sinus syncope.