Age indications for carotid sinus massage: a case for maintaining the status quo?

A 43-year-old man was referred with a history of unexplained falls associated with transient loss of consciousness. He had evidence of cardioinhibitory carotid sinus hypersensitivity (CSH) on carotid sinus massage and subsequently confirmed to have periods of symptomatic asystole on an implantable loop recorder, consistent with a diagnosis of cardioinhibitory CSH.