title: Modified Valsalva manoeuvre to treat recurrent supraventricular tachycardia: description of the technique and its successful use in a patient with a previous near fatal complication of DC cardioversion.
abstract: Patients with attacks of re-entrant supraventricular tachycardia (SVT) frequently present to the emergency department (ED). The Valsalva manoeuvre (VM) is the most effective and safe vagal manoeuvre and advocated as the first-line treatment in stable patients but has a relatively low cardioversion success rate. Improving its efficacy would reduce patients' exposure to the side effects and complications of second-line treatments and has other potential benefits. We describe a modification to the VM, which is currently being studied, and present the case of a 23-year-old patient who was successfully treated with this modified VM after a previous near-fatal complication of direct current (DC) cardioversion.
authors.affiliation: Emergency Department, Royal Devon and Exeter Foundation Trust, Exeter, Devon, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Appelboam
authors.affiliation: Department of Emergency Medicine, Musgrove Park Hospital NHS Foundation Trust, Taunton, Somerset, UK.
authors.forename: James
authors.initials: J
authors.lastname: Gagg
authors.affiliation: Emergency Department, Royal Devon and Exeter Foundation Trust, Exeter, Devon, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Reuben
mesh_terms: D004554:Electric Countershock / Q000009:adverse effects; D004562:Electrocardiography; D006801:Humans; D008297:Male; D012008:Recurrence; D013617:Tachycardia, Supraventricular / Q000628:therapy*; D014636:Valsalva Maneuver; D014693:Ventricular Fibrillation / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult