CAROTID-SINUS MASSAGE AS A DIAGNOSTIC AND THERAPEUTIC TOOL FOR ATRIALFLUTTER-FIBRILLATION

Alterations in vagal tone can influence the atrial fibrillatory proces s by changing the atrial refractory period. We observed in a patient w ith paroxysmal atrial fibrillation (AF) that carotid sinus massage (CS M) changed a ''coarse'' type of fibrillation into a ''fine'' type, fol lowed by termination of the arrhythmia. Although coincidental conversi on of AF into sinus rhythm could not be excluded, we concluded that it is worthwhile to try CSM in every patient presenting with AF prior to other interventions to restore sinus rhythm.