Carotid Sinus Massage & Atrial Pacemaker

Report:

Sinus rhythm 53/min 1

Atrial pacemaker rhythm 41 - 42/min 2

Second degree AV block 3

Single non-conducted paced beat 4

Comment:

Carotid sinus massage may induce AV block regardless of the nature of atrial activation. The patient's response is not abnormal, nor does it imply any pacemaker malfunction.

The pacemaker rate is varies slightly, as it was being adjusted at the same time27. The massage was performed to assess whether the patient would require a ventricular pacemaker as well. It would have been more intelligent by far to have tested the AV nodal response to rapid atrial pacing.

Ventricular pacing would have been less beneficial and could have contributed to hypotension associated with spinal anæsthesia. Its sole indication here would have been a true AV block, not one induced by carotid massage.

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