Valsalva maneuver using a Handmade Device in Supraventricular Tachycardia Reversion; a Quasi Experimental Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e81
https://doi.org/10.22037/aaem.v5i1.206
Abstract
Introduction: The use of vagal nerve stimulation is identified as a proper treatment option in patients with stable supraventricular tachycardia (SVT). This study aimed to assess the success of Valsalva maneuver via a handmade device in reversion of SVT. Methods: In this quasi experimental study, using a handmade device, vagus nerve stimulation was performed for SVT patients presenting to emergency department or cardiac intervention unit and the success rate and its related factors were assessed. Results: 100 patients with the mean age of 53.05 ± 13.70 years were studied (67% female). 12 (12%) cases were unable to do the maneuver. Out of the 88 (88.0%) patients who could perform the maneuver, 75 (85.2%) cases were unsuccessful. Dysrhythmia was controlled in 6 (6.8%) cases on the first attempt and in 7 (8.0%) cases on the second one (14.8% total success rate). 12 of the 13 cases (92.3%) with successful maneuver had history of SVT (p = 0.031). There was not any significant association between success rate and sex (p = 0.084), age (p = 0.744), or other medical histories (p ≥ 0.05). Conclusion: Based on the results of the present study, the success rate of Valsalva maneuver with the mentioned handmade device was calculated to be 14.8%. The only independent related factor of successful reversion was SVT history.- Vagus nerve stimulation
- Valsalva maneuver
- tachycardia
- supraventricular
- arrhythmias
- cardiac
- emergency service
- hospital
How to Cite
References
Orejarena LA, Vidaillet H, DeStefano F, Nordstrom DL, Vierkant RA, Smith PN, et al. Paroxysmal supraventricular tachycardia in the general population. Journal of the American College of Cardiology. 1998;31(1):150-7.
Bibas L, Levi M, Essebag V. Diagnosis and management of supraventricular tachycardias. CMAJ: Canadian Medical Association journal= journal de l'Association medicale canadienne. 2016;188(17-18):E466.
Al-Zaiti SS, Magdic KS. Paroxysmal Supraventricular Tachycardia. Critical Care Nursing Clinics. 2016;28(3):309-16.
Rujic D, Sundbøll J, Tofig B, Nielsen J, Pareek M. Initial evaluation and management of paroxysmal supraventricular tachycardia. Ugeskrift for laeger. 2016;178(3).
Sawan N, Eitel C, Thiele H. Ablation supraventrikulärer Tachykardien. Herzschrittmachertherapie+ Elektrophysiologie. 2016;27(2):143-50.
Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia. Journal of the American College of Cardiology. 2016;67(13):e27-e115.
Chun HM, Sung RJ. Supraventricular tachyarrhythmias: Pharrnacologic versus nonpharrnacologic approaches. Medical Clinics of North America. 1995;79(5):1121-34.
Scheinman M. Supraventricular tachyarrhythmias: drug therapy versus catheter ablation. Clinical cardiology. 1994;17(S2).
Waldo AL. An approach to therapy of supraventricular tachyarrhythmias: an algorithm versus individualized therapy. Clinical cardiology. 1994;17(S2).
Cheng C, Sanders G, Hlatky M, Heidenreich P, McDonald K, Lee B, et al. Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia. 2000.
Link MS. Evaluation and initial treatment of supraventricular tachycardia. New England Journal of Medicine. 2012;367(15):1438-48.
Holdgate A, Foo A. Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults. Cochrane Database Syst Rev. 2006;4.
Delaney B, Loy J, Kelly A-M. The relative efficacy of adenosine versus verapamil for the treatment of stable paroxysmal supraventricular tachycardia in adults: a meta-analysis. European Journal of Emergency Medicine. 2011;18(3):148-52.
Whinnett ZI, Sohaib SA, Davies DW. Diagnosis and management of supraventricular tachycardia. BMJ. 2012;345:e7769.
Waxman MB, Wald RW, Sharma AD, Huerta F, Cameron DA. Vagal techniques for termination of paroxysmal supraventricular tachycardia. The American journal of cardiology. 1980;46(4):655-64.
Wen Z-C, Chen S-A, Tai C-T, Chiang C-E, Chiou C-W, Chang M-S. Electrophysiological mechanisms and determinants of vagal maneuvers for termination of paroxysmal supraventricular tachycardia. Circulation. 1998;98(24):2716-23.
Lim S, Anantharaman V, Teo W, Goh P, Tan A. Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. Annals of emergency medicine. 1998;31(1):30-5.
Smith G. Management of supraventricular tachycardia using the Valsalva manoeuvre: a historical review and summary of published evidence. European Journal of Emergency Medicine. 2012;19(6):346-52.
Ferguson JD, DiMarco JP. Contemporary management of paroxysmal supraventricular tachycardia. Circulation. 2003;107(8):1096-9.
Sohinki D, Obel OA. Current trends in supraventricular tachycardia management. The Ochsner Journal. 2014;14(4):586-95.
Taylor DM, Auble TF, Yealy DM. First-line management of paroxysmal supraventricular tachycardia. The American journal of emergency medicine. 1999;17(2):214-6.
Looga R. The Valsalva manoeuvre—cardiovascular effects and performance technique: a critical review. Respiratory physiology & neurobiology. 2005;147(1):39-49.
Waxman MB, Wald RW, Finley JP, Bonet JF, Downar E, Sharma AD. Valsalva termination of ventricular tachycardia. Circulation. 1980;62(4):843-51.
Taylor DM, Wong LF. Incorrect instruction in the use of the Valsalva manoeuvre for paroxysmal supraâ€ventricular tachycardia is common. Emergency Medicine Australasia. 2004;16(4):284-7.
- Abstract Viewed: 271 times
- PDF Downloaded: 133 times