Mixed carotid sinus hypersensitivity: successful therapy with pacing, ephedrine, and propranolol.
Three forms of carotid sinus hypersensitivity are recognized clinically (cardio-inhibitory, vasodepressor, and mixed). The cardio-inhibitory form has been managed successfully with pacemaker therapy. The vasodepressor element has been difficult to manage clinically whether in its pure form or in combination with the cardio-inhibitory type. We review the various pharmacologic methods previously reported and present our experience with a new pharmacologic alternative, which is the combined use of ephedrine and propranolol to induce unopposed alpha stimulation.
Keating
E C
EC
Burks
J M
JM
Calder
J R
JR
D001794:Blood Pressure / Q000187:drug effects; D001919:Bradycardia / Q000628:therapy*; D002346:Carotid Sinus / Q000294:innervation*; D003131:Combined Modality Therapy; D004809:Ephedrine / Q000627:therapeutic use*; D006321:Heart / Q000294:innervation; D006323:Heart Arrest / Q000628:therapy*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010812:Physical Stimulation; D011433:Propranolol / Q000627:therapeutic use*
D011433:Propranolol; D004809:Ephedrine