Abstract
Following carotid sinus stimulation a hyperactive reflex with ventricular asystole of more than 3 seconds was found in 9 out of 40 asymptomatic patients aged more than 60 years. Results varied considerably between different investigators and different investigation days. Over a period of two years patients with hyperactive reflex did not have a worse prognosis than patients with normal reflex response. Symptoms indicating hypersensitive carotid sinus syndrome had not been observed in a single case. The frequent occurrence of hyperactive carotid sinus reflex and its favourable prognosis and the similarly frequent occurrence of vertiginous attacks due to numerous reasons, in the older age group, do not readily allow for a diagnosis of the hypersensitive carotis sinus syndrome, even when both symptoms occur at the same time. Pacemaker implantation should only be considered when repeated syncope has occurred which cannot be attributed to other causes despite extensive investigations.
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