A Systematic Review Evaluating the Effectiveness of Vagal Methods for Conversion to a Sinus Rhythm in Stable Supraventrical Tachycardia

The preferred first line treatment for adults in stable supraventricular tachycardia (SVT) presenting to an emergency department varies between practitioners. Some practitioners will choose a non-pharmacological intervention as a first line treatment while others will choose a pharmacological intervention. This study analyzes the efficacy of vagal maneuvers in the termination of SVT to sinus rhythm, more specifically comparing Standard Vagal Maneuvers (SVM) to Modified Vagal Maneuvers (MVM). This study was conducted through a systematic review of the literature. The main goal was to increase the use of non-pharmacological interventions as a first line treatment and to raise awareness of the importance efficacy of the intervention to convert SVT to a normal sinus rhythm. The Stetler Model of Evidence-Based Practice guided this systematic review, serving as an example of how research findings are applicable to daily practice, by using evidence to implement change (Stetler, 2001). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using PRISMA, current literature was searched to select randomized control trials in the databases Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed, with the search words “SVT” or “supraventricular tachycardia” or paroxysmal supraventricular tachycardia”, “vagal maneuvers” or “vagal methods”, and “nonpharmacological treatment”. Data from the studies were then appraised using Critical Appraisal Skills Programme (CASP) checklist, then tables were created to organize data clearly, and finally, a cross study analysis table was developed. Three randomized-control trials met the inclusion and exclusion criteria. The findings of the cross-study analysis determined that the modified vagal maneuver is more successful in the conversion of SVT to a sinus rhythm than the standard vagal maneuver.