Comparison of the Modified Valsalva Maneuver and the Standard Valsalva Maneuver for Treatment of Supraventricular Tachycardia in Emergency Department

Abstract

Aim:The diagnosis and initial therapy of supraventricular tachycardia are always made in emergency departments. Vagal maneuvers are recommended as the first-line treatment for the termination of SVT. We aimed to compare the efficacy of standard and modified Valsalva maneuvers in treating patients with SVT.Materials and Methods:This study was conducted between 16/03/2016 and 16/09/2016 at the Health Sciences University Ankara Training and Research Hospital Emergency Medicine Clinic. Our study was a randomized, prospective, case-control study. During the study, standard Valsalva maneuver (SVM) and modified Valsalva maneuver (MVM) were applied to two groups randomly allocated to patients with SVT. The maneuvering technique was determined by the envelope pulling method.Results:This study was enrolled by 47 patients that included 23 patients who were treated by using SVM and 24 patients treated by using MVM. Four (%17,4) people from the patients undergoing SVM returned to sinus rhythm, nine (%37,5) people from the patients who underwent MVM returned to sinus rhythm. ( p > 0.05) Although the results from the MVM treated patients were more satisfying, no statistically significant difference was detected.Conclusion:In this study, we found that MVM is numerically superior in terms of success compared to SVM, but we could not prove this statistically. Therefore, we concluded that there was no difference between the two maneuvers in terms of success. In studies with more cases, we conclude that the result will be statistically significant.

Keywords

• supraventricular tachycardia
• vagal maneuvers
• modified valsalva maneuver