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Cerebral hemodynamics during carotid massage in patients with carotid sinus syndrome.
- Source :
-
Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 1998 Oct; Vol. 21 (10), pp. 1885-92. - Publication Year :
- 1998
-
Abstract
- The effect of cardioinhibition and/or vasodepression on cerebral hemodynamics assessed by transcranial Doppler has been investigated during carotid massage in 11 patients (62-87 years, mean age 72) with carotid sinus syndrome. The patients were tested in the OOO mode (n = 11) with six tested in the DDD mode. Carotid massage in the OOO mode decreased mean arterial pressure by 44% (P < 0.01) and mean cerebral blood flow velocity by 50% (P < 0.01). Although not significant, cerebrovascular resistance increased transiently by 17% during massage, then decreased by 31% upon recovery. Carotid massage in the DDD mode decreased arterial pressure by 30% (P < 0.01), cerebral blood velocity by 23% (P < 0.01), and resistance by 15% (P < 0.05). The decreased cerebral perfusion induced by cardioinhibition and/or vasodepression results from the delayed onset of cerebral autoregulation. Pacing in the DDD mode temporarily assists the critical period preceding the onset of cerebral autoregulation that plays a key role in preventing the deleterious effects of vasodepression.
- Subjects :
- Aged
Blood Flow Velocity physiology
Cardiac Pacing, Artificial methods
Case-Control Studies
Female
Humans
Male
Massage
Syncope therapy
Syndrome
Ultrasonography, Doppler, Transcranial
Carotid Sinus physiopathology
Cerebrovascular Circulation physiology
Pacemaker, Artificial
Syncope physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0147-8389
- Volume :
- 21
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Pacing and clinical electrophysiology : PACE
- Publication Type :
- Academic Journal
- Accession number :
- 9793084
- Full Text :
- https://doi.org/10.1111/j.1540-8159.1998.tb00007.x