Key result
Modified Valsalva increases successful PSVT termination by ~250% versus the standard maneuver.
Why the study?
The relative efficacy of standard versus modified valsalva maneuver in terminating paroxysmal supraventricular tachycardia was unclear.
Does the modified Valsalva maneuver improve the successful return of sinus rhythm compared to the standard Valsalva maneuver in patients with paroxysmal supraventricular tachycardia?
RCT (n=62)
Simple random sampling
No
Does the modified Valsalva maneuver improve the successful return of sinus rhythm compared to the standard Valsalva maneuver in patients with paroxysmal supraventricular tachycardia?
Absolute Event Rate: 11.3% vs 3.2%
The modified Valsalva maneuver is more effective than the standard Valsalva maneuver in terminating paroxysmal supraventricular tachycardia, reducing the need for pharmacological cardioversion.
Modified Valsalva may reduce drug use in PSVT; confirms RCT superiority over standard maneuver.
Aim: To know whether valsalva maneuver is more effective compared to modified valsalva in terminating paroxysmal supraventricular tachycardia or vice versa. Method: The study design was randomized controlled trial. This research was conducted in accident & emergency department of Mayo hospital, Lahore. Duration of this study was nine months. Participants were divided in two groups, half were assigned in Standard VM group (Group A), and other half in Modified VM group (Group B). In both groups, assigned valsalva maneuver was repeated up to two times, only when paroxysmal supraventricular tachycardia did not revert to sinus rhythm on first time. In those patients, VM failed even after three attempts, antiarrhythmic medications were used. Primary outcome was defined on the basis of successful return of sinus rhythm after either by standard or modified valsalva maneuver. Results: Sixty two patients were included in this study, thirty one in each group. Out of thirty one patients in group A, two patients (3.2%) rhythm reverted to sinus, while in group B, seven patients (11.3%) rhythm reverted to sinus. The number of patients who needed rescue treatment was lower in group B -21 (77.4%) as compared to group A- 29(93.5%). Conclusion: The results of this study showed that modified VM was more effective in terminating PSVT as compared to standard VM. So, number of patients who required pharmacological cardioversion was lower in group B.
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Shoukat et al. (2023) conducted an RCT in Paroxysmal Supraventricular Tachycardia (PSVT) (n=62). Modified Valsalva maneuver vs. Standard Valsalva maneuver was evaluated on Successful return of sinus rhythm. The modified Valsalva maneuver was more effective than the standard Valsalva maneuver in terminating paroxysmal supraventricular tachycardia, achieving sinus rhythm in 11.3% of patients compared to 3.2%.
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