Modified Valsalva Maneuver Increases

Conversion of Paroxysmal Supraventricular

Tachycardia
Pallin, Daniel J . NEJM Journal Watch. Emergency Medicine ; Waltham (Jun 9, 2017).

Link dokumen ProQuest

ABSTRAK (ENGLISH)
A small Turkish trial provides good evidence for employing this low-risk practice.

TEKS LENGKAP
Paroxysmal supraventricular tachycardia (PSVT) is treated with vagal maneuvers, including the Valsalva
maneuver, followed by medication or electrical cardioversion if vagal maneuvers are unsuccessful. Turkish
investigators performed a randomized, controlled trial comparing the standard Valsalva maneuver with a
previously described modified Valsalva maneuver in 56 patients with PSVT (NEJM JW Emerg Med Oct 2015 and
Lancet2015; 386:1747.)
In the standard group (control), the seated patient was asked to blow into the tip of a 10-mL syringe for 15
seconds, hard enough to move the plunger. In the modified group (experimental), the same procedure was used
but was followed by quickly bringing the patient to a supine position and then lifting the patient's legs to a 45-
degree angle. The procedure was repeated three times, and if unsuccessful, was followed by other interventions as
needed. Sinus rhythm was restored in 11% of the standard group and 43% of the modified group after the vagal
maneuver, a significant difference of 32%. Adverse events were mild and rare, limited to dizziness and dyspnea,
each occurring once in each group.
These results are remarkably similar to those of the prior study. There is little downside to the modified Valsalva
maneuver described here, and I will use it for my patients with PSVT.
Credit: Daniel J. Pallin, MD, MPH
References
Çorbacioglu SK et al. Comparing the success rates of standard and modified Valsalva maneuvers to terminate
PSVT: A randomized controlled trial. Am J Emerg Med 2017 May 22; [e-pub].
(http://dx.doi.org/10.1016/j.ajem.2017.05.034)

DETAIL

Subjek: Shoulder; Cardiac arrhythmia; Clinical trials

Judul: Modified Valsalva Maneuver Increases Conversion of Paroxysmal Supraventricular

Tachycardia

Pengarang: Pallin, Daniel J

Judul publikasi: NEJM Journal Watch. Emergency Medicine; Waltham

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 Tahun publikasi: 2017

Tanggal publikasi: Jun 9, 2017

Penerbit: Massachusetts Medical Society

Tempat publikasi: Waltham

Negara publikasi: United States, Waltham

Subjek publikasi: Medical Sciences--Orthopedics And Traumatology

ISSN: 23300531

Jenis sumber: Scholarly Journals

Bahasa publikasi: English

Jenis dokumen: News

DOI: http://dx.doi.org/10.1056/nejm-jw.NA44255

ID dokumen ProQuest: 1907733598

URL Dokumen: https://search.proquest.com/docview/1907733598?accountid=50268

Hak cipta: Copyright © 2017 Massachusetts Medical Society. All rights reserved.

Terakhir diperbarui: 2017-06-12

Basis data: Public Health Database

Hak cipta basis data  2019 ProQuest LLC. Semua hak cipta dilindungi.

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