A modified Valsalva manoeuvre results in greater termination of supraventricular tachycardia than standard Valsalva manoeuvre

Commentary on: Appelboam A, Reuben A, Mann C, et al., REVERT trial collaborators. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet 2015;386:1747–1753.[OpenUrl][1][CrossRef][2][PubMed][3] Supraventricular tachycardia (SVT) involves re-entry mechanisms established within (or including) the atrioventricular node (AVN), and affects some 35 in 100 000 people.1 As SVT is episodic and usually transient, the least invasive method of termination is preferable, with the simplest being the Valsalva manoeuvre (VM). Vagal manoeuvres are not a definitive therapy as no clinically significant value for vagal tone generation to terminate SVT has been identified.2 This randomised trial compares two variations of VM performance using patients with SVT in the hospital setting, identifying optimum effectiveness through reversion. This was a randomised multicentre parallel group trial of a stay sitting VM (SVM) using … [1]: {openurl}?query=rft.jtitle%253DLancet%26rft.volume%253D386%26rft.spage%253D1747%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252815%252961485-4%26rft_id%253Dinfo%253Apmid%252F26314489%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0140-6736(15)61485-4&link_type=DOI [3]: /lookup/external-ref?access_num=26314489&link_type=MED&atom=%2Febmed%2F21%2F2%2F61.atom