ABSTRACT This review examines the pathogenesis of Carotid Sinus Hypersensitivity (CSH) by describing the different hypotheses that exist in literature. One hypothesis is that CSH is not a disease of the heart but of the central and/or peripheral nerv- ous system where the heart is the victim. CSH is associated with cognitive disturbance, vasovagal syncope and ortho- static hypotension. Another hypothesis is that the CSH is considered a syndrome or a symptom associated with different diseases so as to require a diagnostic framework. This Hypothesis is the basis of frequent recurrences that are associated with the pacemaker implant therapy only.
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