Carotid Sinus Massage

The carotid sinus massage is a useful vagal maneuver that can terminate paroxysmal supraventricular tachycardia by directly stimulating the carotid baroreceptor. To perform the maneuver, first identify the bifurcation of the common carotid artery by palpation lateral to the trachea. Then, confirm the absence of carotid artery disease by reviewing the patient’s history. One may additionally auscultate for bruits in the carotid region. Next, apply gentle pressure to the bifurcation of the common carotid artery for 5 seconds. The success rate of the carotid sinus massage is 10.5%. If the arrhythmia continues, IV adenosine can be considered for the termination of PSVT.

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Click    • Modified Valsalva Maneuver   to watch demonstration of the modified Valsalva maneuver.