St. Emlyn´s - August 28, 2015 by Rick Body
"So what does this MEAN?
Clearly, the findings are pretty impressive. The modified Valsalva is safe and can cardiovert 43% of patients with SVT. By using the modified Valsalve instead of a standard technique, we could avoid using adenosine in one out of every 5.3 patients treated, which isn’t bad. What’s more, this is a pretty robust trial with no major weaknesses. My only remaining question is whether you need to adopt the Trendellenberg position after the strain or whether being in the supine position all along would be just as effective. I’ve always been taught that the Valsalva manoeuvre is more effective in the supine position. However, based on these data, I’ll certainly be changing my practice and using the modified Valsalva technique as shown in the video.
It also has some more implications. If we teach patients how to do this themselves, maybe they can self-cardiovert without coming to the ED or using a pill in the pocket. From a patient’s perspective, this could be great."
http://stemlynsblog.org/the-revert-trial/