J Korean Soc Emerg Med.  2019 Apr;30(2):176-182. 10.0000/jksem.2019.30.2.176.

Pilot study for a novel delta carotid sinus massage in increasing parasympathetic tone: a randomized, prospective, cross-over, comparative study with conventional method

• Lee DI
• Shin TY
• Toh HC
• Lee MJ
• Ahn JH

• KMID: 2447770
• DOI: http://doi.org/10.0000/jksem.2019.30.2.176

Abstract

OBJECTIVE
This study examined the efficacy of new delta carotid sinus massage (CSM) versus conventional CSM (CM).
METHODS
This prospective, cross-over study was conducted on 26 healthy volunteers with a normal sinus rhythm. CM and delta CSM (DM) were performed in all participants. In both cases, the CSM was performed, where the maximal carotid pulse was palpated. DM differed from CM in that the physician moves the palpating finger in the opposite direction of the carotid pulse at least twice. The mean and longest R-R intervals and mean and lowest heart rates (HRs) at the baseline and during the procedure for each technique were compared. The mean differences between the baseline and procedure R-R intervals and the HRs for each technique were also evaluated.
RESULTS
The baseline mean and longest R-R intervals and baseline mean and lowest HRs were similar both groups (P>0.05). The procedure DM mean and longest R-R intervals (22.7±3.1, 26.4±4.9) were significantly greater than the CM corresponding values (22.0±3.1, 24.6±3.5; P<0.001, P=0.003). Procedure DM mean and lowest HRs (67.3±9.7, 58.6±10.7) were significantly lower than the CM corresponding values (69.4±10.0, 61.8±8.9; P=0.001, P=0.003). The differences in the R-R interval and HR between the procedure and baseline were significant (mean and longest R-R intervals with CM [1.3±1.5 and 2.1±1.9] vs. DM [2.0±1.4 and 3.8±3.1], P<0.001, P=0.004; mean and lowest HRs with CM [4.2±4.3 and 5.8±4.6] vs. DM [6.3±4.6 and 9.1±6.5], P<0.001, P=0.005).
CONCLUSION
DM is more effective in generating a more potent vagal tone than CM.

Keyword

Carotid sinus; Massage; Electrocardiography; Heart rate

MeSH Terms

Carotid Sinus*
Cross-Over Studies
Electrocardiography
Fingers
Healthy Volunteers
Heart Rate
Massage*
Methods*
Pilot Projects*
Prospective Studies*