Observation of the effect of postural modified Valsalva manoeuvre in terminating paroxysmal supraventricular tachycardia

Abstract

Objective To observe the efficacy and safety of postural modified Valsalval manoeuvre in terminating paroxysmal supraventricular tachycardia (PSVT). Methods From January 2017 to June 2018, a total of 98 patients with PSVT were selected in the Affiliated Hospital of Xuzhou Medical University.They were randomly allocated to standard Valsalval manoeuvre group(48 cases) and postural modified Valsalval manoeuvre group(50 cases) according to sealed envelope method.The patients in standard Valsalval manoeuvre group carried out standard semi-recumbent Valsalva manoeuvre, while the other group received semi-recumbent with supine repositioning and passive leg raise immediately after the Valsalva strain.The general clinical data, total cardioversion success rate, first-time cardioversion success rate and the incidence of adverse reactions were compared between the two groups. Results There were no statistically significant differences in male proportion, age, history of PSVT or coronary heart disease, incidence of hypertension, diabetes and heart rate, systolic and diastolic blood pressure at attack between the two groups(all P>0.05). The total cardioversion success rate [40.0%(20/50)], first-time cardioversion success rate [28.0%(14/50)] in the modified group were significantly higher than those in the standard group [16.7%(8/48), 12.5%(6/48)](χ2=27.924, 16.308, all P 0.05). Conclusion Postural modified Valsalval manoeuvre can effectively improve the cardioversion success rate of PSVT, and has high safety, which is worthy of clinical promotion. Key words: Tachycardia, supraventricular; Valsalval manoeuvre; Syringe; Mechanical stimulation; Vagus nerve; Treatment outcome; Comparative effectiveness research