Bainbridge vs Bezold-Jarisch reflex – who wins in neurocardiogenic syncope?

The original tracing of the bainbridge reflex
The original tracing of the bainbridge reflex

About a century ago, Bainbridge described his reflex (if not under that name), namely increase of heart rate provoked by increased venous return. Although it has long been debated how big a role it plays in human vs. canine physiology, it is the physiologic foundation for respiratory arrhythmia, the effect of metronomic breathing on heart rate (as measured during autonomic testing) and many more phenomena.

In neurocardiogenic syncope it might play a role in the final bradycardic phase, but more likely is that it is far overtaken by yet another physiologic (and similarly controversial) reflex named after Bezold and Jarisch.

If all that confuses you, then take a look at this recent anesthesiologic article.

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