Carotid Sinus Hypersensitivity

This patient presented to the hospital with syncope (loss of consciousness) that occurred while he was looking skyward to watch the Chicago Air and Water show. The tracing above was obtained during Carotid Sinus Massage. The pause in heart rate that followed the carotid massage reproduced his syncope. He ultimately was treated with a pacemaker and low dose Flurinef (to counteract the vasodepressor component of his carotid sinus massage) and has done quite well.