Atrial fibrillation precipitated by carotid sinus massage in a patient with unexplained syncope.

BACKGROUND

Carotid sinus massage (CSM) is a useful tool in the investigation of unexplained syncope, but is associated with risks.

AIM

To describe the first reported case of atrial fibrillation precipitated by CSM during the investigation of a patient with recurrent unexplained syncope.

RESULTS

A 58-year-old female underwent CSM as part of a tilt test protocol for the investigation of recurrent unexplained syncope. Left CSM revealed the diagnosis of mixed cardioinhibitory and vasodepressor carotid sinus syndrome but also precipitated atrial fibrillation, an arrhythmia previously unreported as a complication of the procedure.

CONCLUSIONS

CSM is a useful tool in the investigation of patients with recurrent unexplained syncope, but may cause atrial fibrillation in addition to other previously described complications and should, therefore, be used with caution.