Management

Patients with a clinical diagnosis of carotid sinus syndrome and two or more episodes of syncope should be given a dual chamber pacemaker (1)

• will abolish syncope in 90% of patients (1)
  • American College of Cardiology/American Heart Association/Heart Rhythm Society clinical practice guidelines consider permanent pacing therapy to be a class I indication (ie, general agreement exists that the therapy is effective and useful) in patients with recurrent syncope caused by carotid sinus stimulation in the absence of any drug that depresses the sinus node or atrioventricular conduction

Reference:

• EBM 1999; 4 (6): 170.
• Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol. May 27 2008;51(21):e1-62