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Cerebral Hemodynamics During Carotid Massage in Patients with Carotid Sinus Syndrome
Author(s) -
LEFTHERIOTIS GEORGES,
ROZAK PHILIPPE,
DUPUIS JEANMARC,
VICTOR JACQUES,
TADEI ANDRE,
SAUMET JEAN LOUIS
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb00007.x
Subject(s) - medicine , carotid sinus , massage , transcranial doppler , cerebral blood flow , hemodynamics , cerebral perfusion pressure , cerebral autoregulation , blood pressure , anesthesia , cardiology , autoregulation , mean arterial pressure , cerebral circulation , heart rate , pathology , alternative medicine
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.