# Carotissinushypersensitiviteit en orthostatische hypotentie komen frequent samen bij syncope — Europace

*geplaatst 2026-11-12 · Atriumfibrilleren · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · doi 10.1093/europace/euag295 · https://hartvaat.nl/2026/11/04/carotissinushypersensitiviteit-en-orthostatische-hypotentie-komen-frequent-samen/*

In een cohort van 1908 patiënten ouder dan 40 jaar met onverklaarde syncope onderzochten auteurs de samenhang tussen carotissinushypersensitiviteit (CSH) en orthostatische hypotentie (OH). OH werd vastgesteld bij 32,4% van de patiënten, waarvan 46,6% ook CSH vertoonde; CSH was significant vaker aanwezig bij OH-patiënten (24,1% versus 13,3%, p < 0,001). Een asystolische respons op carotissinusmassage kwam vaker voor bij OH en hing samen met hogere leeftijd en een lagere rusthartslag. Deze bevindingen ondersteunen het advies om bij syncope-complaints systematisch te screenen op autonome dysfunctie, omdat de combinatie van beide aandoeningen de diagnostiek en verdere afweging van de oorzaak beïnvloedt.

## English: Carotid sinus hypersensitivity and orthostatic hypotension in unexplained syncope.

In a cohort of 1908 patients aged 40 years or older with unexplained syncope, researchers evaluated the coexistence of carotid sinus hypersensitivity (CSH) and orthostatic hypotension (OH). Orthostatic hypotension was present in 32.4% of participants, and 46.6% of those with OH also had CSH; CSH was significantly more frequent in the OH group (24.1% vs 13.3%, p < 0.001). Asystolic responses to carotid sinus massage were more common in OH patients and associated with older age and lower resting heart rate. These findings support routine comprehensive autonomic testing in syncope workups, as the frequent coexistence of CSH and OH may alter diagnostic pathways and management strategies.

## Abstract (original, from the publication)

AIMS: Carotid sinus hypersensitivity (CSH) and orthostatic hypotension (OH) are established causes of syncope but are often considered separate entities. However, evidence suggests that CSH and OH may coexist and jointly contribute to syncope. This study investigates the relationship between CSH and OH in patients with unexplained syncope. METHODS AND RESULTS: A total of 1908 patients aged ≥40 years (age, 63.7 ± 13.0 years; men, 45.3%) with unexplained syncope underwent carotid sinus massage (CSM) and head-up tilt testing (HUT). Occurrence of CSH in classical and delayed OH, including asystolic CSM responses was analysed. Six-hundred-and-eighteen patients (32.4%, 68.9 ± 11.3 years) had OH, while CSH was present in 320 patients (16.8%, 72.2 ± 9.9 years), and was more common in patients with OH than without OH (24.1% vs. 13.3%, P < 0.001). Among patients with CSH, 46.6% also had OH. CSH occurred equally in both classical OH (62/275, 22.5%) and delayed OH (87/345, 25.2%). Among OH patients, CSH was associated with older age, male sex, lower supine diastolic blood pressure, hypertension, and syncope-related hospital admission. An asystolic CSM response was observed more often in OH patients (n = 42; 6.8%) compared with non-OH patients (n = 44, 3.4%, P < 0.001) and was associated with older age and lower resting heart rate. CONCLUSION: CSH and OH frequently coexist in adults over 40 years evaluated for syncope. CSM may reveal a clinically relevant cardioinhibitory reflex in a subgroup of OH patients, supporting comprehensive cardiovascular autonomic testing in unexplained syncope.

Auteurs: Sara Hassan, Hannes Holm, Frederik de Lange, Rose Anne Kenny, Michele Brignole, Artur Fedorowski

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Bron: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, https://doi.org/10.1093/europace/euag295. Bijgewerkt 2026-11-05T02:32:15Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.