Nicoladoni-Branham sign – Mechanism

  • Compression of the artery proximal to an arteriovenous fistula results in reflex bradycardia
  • This phenomenon is known as Nicoladoni-Branham sign


  • AV fistula is a volume overload state
  • When the artery supplying the AV fistula is compressed, there is an increase in peripheral vascular resistance and afterload
  • As a result of increased afterload, there is reflex bradycardia

Alternate names:

  • Branham sign
  • Nicoladoni-Israel-Branham sign

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