Effectiveness of the Valsalva Manoeuvre for reversion of supraventricular tachycardia

Smith, Gavin D, Dyson, Kylie, Taylor, David, Morgans, Amee, Cantwell, Kate

Patients with the cardiac arrhythmia supraventricular tachycardia (SVT) frequently present to clinicians in the prehospital and emergency medicine settings. Restoring sinus rhythm by terminating the SVT involves increasing the refractoriness of AV nodal tissue within the myocardium by means of vagal manoeuvres, pharmacological agents or electrical cardioversion. A commonly used first-line technique to restore the normal sinus rhythm (reversion) is the Valsalva Manoeuvre (VM). This is a non-invasive means of increasing myocardial refractoriness by increasing intrathoracic pressure for a brief period, thus stimulating baroreceptor activity in the aortic arch and carotid bodies, resulting in increased parasympathetic (vagus nerve) tone.