Carotid sinus massage will terminate: March 2005

Ans. D: Suprventicular tachycardia Carotid sinus massage is a simple bedside maneuver that helps to clarify the type and sometimes also the mechanism of different rhythm disturbances. The major indication for carotid sinus massage is the diagnosis of tachyarrhythmias in which the atrial activity is either absent or intermittently present. Carotid sinus massage is also useful in altering conduction within the AV node. Vagal stimulation,such as occurs with the Vasalva maneuver or carotid sinus massage can slow conduction in the AV Node sufficiently to terminate AVN/ PSVT (aerioventricular nodal reentrant tachycardia). It is also helpful in some patients with normal hea rates; increased vagal tone may normalize a bundle branch block or localize the site of type I second-degree atrioventricular block and can be used for evaluation of the sensing function of permanent pacemakers. Carotid sinus massage is also an impoant diagnostic procedure in patients with suspected hypersensitivity of the carotid sinus. Massage of the carotid sinus is contraindicated in patients with diseased carotid aeries because of the risk of cerebrovascular accident. In rare instances, carotid sinus massage may initiate ventricular tachycardia.