Cardiac pacing reduced nonaccidental falls in older adults with cardioinhibitory carotid sinus hypersensitivity.
نویسنده
چکیده
Patients 175 patients > 50 years of age (mean age 73 y, 59% women) with cardioinhibitory CSH who reported to the emergency department because of a non-accidental fall. Exclusion criteria included cognitive impairment (MiniMental State Examination score < 24), a medical cause for the fall within 10 days of presentation, an accidental fall, blindness, contraindication to carotid sinus massage (CSM), and use of drugs known to cause hypersensitivity to CSM. Follow up was 91%.
منابع مشابه
Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE).
OBJECTIVES The aim of the study was to determine whether cardiac pacing reduces falls in older adults with cardioinhibitory carotid sinus hypersensitivity (CSH). BACKGROUND Cardioinhibitory carotid sinus syndrome causes syncope, and symptoms respond to cardiac pacing. There is circumstantial evidence for an association between falls and the syndrome. METHODS A randomized controlled trial wa...
متن کاملDiagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential.
OBJECTIVE To assess the diagnostic value of supine and upright carotid sinus massage in elderly patients. DESIGN Prospective controlled cohort study. SETTING Three inner city accident and emergency departments and a dedicated syncope facility. PATIENTS 1375 consecutive patients aged > 55 years presenting with unexplained syncope and drop attacks; 25 healthy controls. INTERVENTIONS Bilat...
متن کاملCarotid sinus massage in patients who fall: will it define the role of pacing?
In this era of diagnostic and therapeutic glitz, can a simple, safe, and universally applicable clinical maneuver—carotid sinus massage—favorably affect a clinical outcome in a large number of patients? Possibly. In this issue of the Journal, Kenny et al. (1) have evaluated patients presenting to an emergency room because of an unexplained fall. In a prospective randomized study they assessed t...
متن کاملCardioinhibitory carotid sinus hypersensitivity predicts an asystolic mechanism of spontaneous neurally mediated syncope.
AIMS We correlated the finding of cardioinhibitory carotid sinus hypersensitivity (CSH) with that observed during a spontaneous syncopal relapse by means of an implantable loop recorder (ILR). METHODS AND RESULTS We included 18 consecutive patients with suspected recurrent neurally mediated syncope and positive cardioinhibitory response during carotid sinus massage (max pause 5.5 +/- 1.6 s) w...
متن کاملCarotid sinus syndrome: Progress in understanding and management
Carotid sinus syndrome (CSS) is a disease of the autonomic nervous system presenting with syncope, especially in older males who often have cardiovascular disease. The aetiology is unknown and epidemiological data is limited. Forty new patients/million population have been estimated to require pacing for CSS and these patients represent ∼9% of those presenting syncope to a specialist facility. ...
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ورودعنوان ژورنال:
- ACP journal club
دوره 137 1 شماره
صفحات -
تاریخ انتشار 2002