Monday, January 17, 2022

Modified Valsalva Maneuver

REBEL EM - January 10, 2022 - By Miguel Reyes
Article: Abdulhamid AS et al. Modified Valsalva Versus Standard Valsalva for Cardioversion of Supraventricular Tachycardia: Systematic Review and Meta-Analysis. International Journal of Arrhythmia 2021. [Link is HERE]
Clinical Question: Is the modified Valsalva maneuver (mVm) more successful than the standard Valsalva maneuver (sVm) at converting SVT to normal sinus 
Authors Conclusion:
“Our review found MVM to be more effective than SVM in terminating SVT. This should encourage broader adoption of the MVM as a first-line vagal maneuver in subjects presenting with SVT in the emergency room.”
Clinical Take Home Point
  • In patients with hemodynamically stable SVT the modified Valsalva maneuver should be the first line treatment as it is more effective than standard treatment in converting patients to NSR. It is simple, costs nothing, has similar adverse events, and similar time spent in the ED as standard Valsalva maneuver.