Effectiveness of the modified valsalva maneuver in the emergency management of supraventricular tachycardia

Abstract

Background: The return rate of supraventricular tachycardia (SVT) to sinus rhythm by the standard Valsalva maneuver (SVM) is as low as 5%–20%. Despite the limited available data in the literature, the modified Valsalva maneuver (MVM) is promising. We tested the effectiveness of the MVM for the emergency treatment of patients with SVT. Materials and Methods: In this cohort prospective study, 93 confirmed SVT cases with mean age of 47.88 ± 15.66 years and female: male ratio (1.73) across multiple centers underwent MVM. The reversion to sinus rhythm after 1 min of the maneuver, in the first or second attempt, was considered to be a success, and other conditions were considered to be a failure. Alternative therapies were administered for nonresponders. Results: The overall success rate of the reversion of SVT to sinus rhythm by using MVM in this study is 47.3%. In addition, the rate was not affected by medical and drug histories, and the rate was not substantially different among the patients having different sociodemographics, blood pressures, and pulse rate statuses. MVM has a high cardioversion rate when used for patients with SVT. We recommend using it instead of the SVM as the first-line nonpharmacologic therapy for SVT. Conclusion: The MVM has a very reasonable cardioversion rate in the setting of emergency treatment of SVT regardless of the associated sociodemographic and medical histories of patients.