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

2021 ◽  
Vol 20 (4) ◽  
pp. 230-235
Author(s):  
Yahya Kemal Günaydın ◽  
Fuat Koray Çelik ◽  
Sertaç Güler ◽  
Dilber Ucoz Kocasaban
Keyword(s):  
Emergency Department ◽  
Supraventricular Tachycardia ◽  
Valsalva Maneuver

scholarly journals Modified valsalva versus standard valsalva for cardioversion of supraventricular tachycardia: systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ahmed S. Abdulhamid ◽  
Fahad Almehmadi ◽  
Abdullah A. Ghaddaf ◽  
Mohammed S. Alomari ◽  
Amin Zagzoog ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Emergency Room ◽  
Supraventricular Tachycardia ◽  
Valsalva Maneuver ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
First Line ◽  
Eligibility Criteria

Abstract Background Supraventricular tachycardia (SVT) is a major cause of emergency room visits where vagal maneuver is used as first-line therapy. The valsalva maneuver (VM) is proven to be safe and, to some extent, effective in terminating SVT episodes. We aimed to compare the standard VM (SVM) to the modified valsalva maneuver (MVM). We hypothesized that MVM is more effective in terminating SVT episodes and reducing the time spent in the emergency department. Methods In this systematic review and meta-analysis, we searched Medline/PubMed, Ovid, Web of Science, and Cochrane Central Register of Controlled trials. We included only randomized controlled trials (RCTs) that compared the modified valsalva to the standard valsalva maneuver in treating SVT. Our main outcome was the termination of SVT within 1 min. Results Four articles met the eligibility criteria of our review. Sinus rhythm was achieved 2.5 times more in the MVM group compared to the SVM group (risk ratio (RR) = 2.54, CI 1.98–3.24, P < 0.001) and thus lowered the need of intravenous SVT termination medication without any significant increase in adverse events or time spent in the emergency department. Conclusion Our review found MVM to be more effective than the SVM in terminating SVT. This should encourage broader adoption of the MVM as a first-line vagal maneuver in subjects presenting with SVT in the emergency room.

Evaluation and acute management of wide QRS complex tachycardia

ESC CardioMed ◽  
2018 ◽  
pp. 2256-2259
Author(s):  
Sei Iwai ◽  
Jason Jacobson
Keyword(s):  
Emergency Department ◽  
Ventricular Tachycardia ◽  
Supraventricular Tachycardia ◽  
Hospital Setting ◽  
Acute Management ◽  
Qrs Complex ◽  
Haemodynamic Stability ◽  
Clinical Challenge ◽  
Qrs Duration

Wide QRS complex tachycardia (WCT) is a common clinical challenge, and can present in a variety of settings, including the emergency department, in the in-hospital setting, during operations, and even in the outpatient arena. The proper, and timely, acute management of WCT is contingent on the proper evaluation and diagnosis of the tachycardia. WCT, an arrhythmia with a QRS duration of over 120 ms, at a rate of over 100 beats per minute, can be due to either supraventricular tachycardia with aberrant conduction or due to ventricular tachycardia. The management of these two entities can vary considerably, especially if the patient presents without significant haemodynamic stability.

scholarly journals A prehospital treat-and-release protocol for supraventricular tachycardia

CJEM ◽  
2015 ◽  
Vol 17 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Rajan Minhas ◽  
Gregory Vogelaar ◽  
Dongmei Wang ◽  
Wadhah Almansoori ◽  
Eddy Lang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Supraventricular Tachycardia ◽  
Significant Proportion ◽  
Prehospital Setting ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Single Individual ◽  
Viable Option ◽  
The Impact ◽  
The City ◽  
Alberta Health

ABSTRACTObjectiveParoxysmal supraventricular tachycardia (SVT) is a common dysrhythmia treated in the prehospital setting. Emergency medical service (EMS) agencies typically require patients treated for SVT to be transported to the hospital. This retrospective cohort study evaluated the impact, paramedic adherence, and patient re-presentation rates of a treat-and-release (T+R) protocol for uncomplicated SVT.MethodsData were linked from the Alberta Health Services EMS electronic patient care record (EPCR) database for the City of Calgary to the Regional Emergency Department Information System (REDIS). All SVT patients treated by EMS between September 1, 2010, and September 30, 2012, were identified. Databases were queried to identify re-presentations to EMS or an emergency department (ED) within 72 hours of T+R.ResultsThere were 229 confirmed SVT patient encounters, including 75 T+R events. Of these 75 T+R events, 10 (13%, 95% confidence interval [CI] [7.4, 23]) led to an EMS re-presentation within 72 hours, and 4 (5%, 95% CI [2.1, 13]) led to an ED. All re-presentations were attributed to a single individual. After excluding 15 records that were incomplete due to limitations in the EPCR platform, 43 of 60 (72%) T+R encounters met all protocol criteria for T+R.ConclusionThe T+R protocol evaluated in this study applied to a significant proportion of patients presenting to EMS with SVT. Risk of re-presentation following T+R was low, and paramedic protocol adherence was reasonable. T+R appears to be a viable option for uncomplicated SVT in the prehospital setting.

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