Effect of carotid sinus massage in terminating the episodes of supraventricular tachycardia

Abstract

Supraventricular tachycardia (SVT) is a common cardiac arrhythmia marked by an abnormally fast heart rate, leading to significant patient discomfort and frequent visits to emergency departments. Carotid sinus massage (CSM) is a widely used vagal maneuver employed to rapidly stop SVT episodes. This research investigates the success and safety profile of CSM in treating SVT among Pakistani patients, offering critical insights for its use in emergency medical practices. A prospective observational cohort study was carried out in the Medicine Department of CMH Hospital, Multan, Pakistan, from January 1, 2024 to June 30, 2024. The study included 200 SVT patients aged 18 and older who presented at the emergency department. Information on patient demographics, medical history, and current clinical status was documented. Patients were laid supine with little neck extension. Gentle pressure was applied to the carotid sinus for 5 to 10 seconds on alternating sides, with a 1-minute interval if needed. The effectiveness of the procedure was determined by the rate of SVT termination, defined as a return to normal sinus rhythm within 30 seconds. Safety was monitored by noting any adverse events during and after the procedure. The average age of the study participants was 55.55 ± 8.86 years. Females made up 59.5% of the sample. CSM successfully terminated SVT in 18.5% of the cases. Adverse effects that were reported included dizziness (3.5%), vomiting (2.5%), syncope (1.5%), exacerbation of arrhythmia (3.5%), and temporary neurological issues (1%). This study assessed the effectiveness and safety of CSM in managing SVT. The findings indicate an 18.5% success rate in SVT termination, consistent with previous studies. Despite moderate efficacy and some side effects, CSM remains a valuable non-pharmacological approach for SVT management, with certain contraindications to be considered.