In the REVERT trial, 433 patients who presented to the emergency department in England with supraventricular tachycardia were randomly assigned to undergo either a standard or a modified semi-recumbent Valsalva manoeuvre. The modification involved supine repositioning and passive leg raise immediately after the Valsalva strain, and resulted in 43% of patients achieving sinus rhythm within 1 min of the intervention, compared with 17% of those who underwent the standard manoeuvre (OR 3.7, 95% CI 2.3–5.8, P <0.0001). The investigators recommend that “in patients with supraventricular tachycardia, a modified Valsalva manoeuvre ... should be considered as a routine first treatment and can be taught to patients”.
References
Appelboam, A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet 10.1016/S0140-6736(15)61485-4
Rights and permissions
About this article
Cite this article
Modified Valsalva manoeuvre increases return to sinus rhythm from supraventricular tachycardia. Nat Rev Cardiol 12, 623 (2015). https://doi.org/10.1038/nrcardio.2015.149
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrcardio.2015.149
