Carotid sinus pressure: a new application of an old maneuver. A preliminary report.
This study reveals the capability of carotid sinus pressure (CSP) in distinguishing aberrant ventricular complexes from ventricular ectopy in atrial fibrillation. Nine patients with atrial fibrillation and frequent (> 10/min) single and/or repetitive wide QRS-complexes (duration > 0.12 s) participated. None of them were on antiarrhythmic medication, included digitalis. CSP was performed during ECG monitoring and the response to it was arbitrarily designated positive if it resulted in slowing of the ventricular rate and a temporary abolition of wide QRS-complexes. The origin of wide QRS-complexes was verified by an i.v. bolus of adenosine and/or lidocaine. Our results showed that CSP resolved aberrant beats in 85.7% (six of seven patients) and had high specificity (100%), accuracy (88.9%) and predictive value (100%). In conclusion, CSP can be used as a simple bedside technique to distinguish the origin of wide QRS-complexes.
Raev
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Department of Intensive Care, Central Clinical Hospital, Sofia, Bulgaria.
D000241:Adenosine / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D002346:Carotid Sinus / Q000187:drug effects / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; D000241:Adenosine