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The effects of carotid sinus pressure in re-entrant paroxysmal supraventricular tachycardia
Authors:M E Josephson  S E Seides  W B Batsford  A R Caracta  A N Damato  J A Kastor
Affiliation:1. Cardiopulmonary Laboratory, United States Public Health Service Hospital, Staten Island, N. Y., USA;2. the Hospital of the University of Pennsylvania, Philadelphia, Pa., USA;3. the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pa., USA
Abstract:
The effect of carotid sinus pressure (CSP) on paroxysmal atrial tachycardia (PAT) was studied in eighteen patients. In twelve of the thirteen patients in whom CSP terminated the arrhythmia, gradual slowing occurred prior to conversion to sinus rhythm. With the use of His-bundle electrograms it could be demonstrated that this slowing was due to prolongation of conduction through the A-V nodal re-entrant pathway (increased A-H interval). Thus, slowing of a supraventricular tachycardia in response to CSP does not rule out the possibility that the arrhythmia is PAT. Further vagal maneuvers may, therefore, be indicated in the diagnosis and management of such an arrhythmia.
Keywords:Reprint requests: Dr. Mark E. Josephson   Section of Cardiology   Hospital of the University of Pennsylvania   Philadelphia   Pa. 19104.
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