Modified positional valsalva
2015 REVERT Trial
- Found for SVT resolution to NSR:
- Normal Valsalva - 17% resolution
- Modified Positional Valsalva - 43% resolution
- No adverse events or costs associated with Modified Positional Valsalva
- 10ml syringe with plunger
- Two assistants - one to adjust head of bed and another to raise/lower legs.
- Position patient with legs flat and head of bed to 45°
- Have patient attempt to blow out plunger of 10ml syringe (or Valsalva around 40mmHg) for 15 seconds.
- Then quickly reposition patients head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds.
- Return patient to head of bed at 45° and continue to monitor for resolution for 1 minute.
- Repeat if needed.
- Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial fulltext