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L. H. Landay, M.D.
JAMA. 1941;117(20):1728. doi:10.1001/jama.1941.02820460066024.
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To the Editor:—  Your editorial (The Journal, October 4, p. 1185) on carotid sinus syncope was timely. The syndrome is not at all rare and can be diagnosed by any physician interested in looking for it.I have seen several active cases in the past year. An electrocardiogram taken on 1 of these patients while pressure was made on the right carotid sinus shows complete cardiac asystole of over seven seconds, then a ventricular escape; another period of asystole of about three seconds and a ventricular escape; then a period of asystole of three seconds and complete systole which is preceded by syncope and convulsive seizure.If one has the assistant mark the electrocardiogram as soon as pressure is made, one notes that the response is immediate, usually less than two tenths of a second. I have fortunately not had any serious effects as a result of pressure on the


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