Modified positional valsalva
Background
2015 REVERT Trial
- Studied modified Valsalva for SVT conversion to normal sinus:[1]
- Normal Valsalva - 17% resolution
- Modified Positional Valsalva - 43% resolution
- No adverse events or costs associated with Modified Positional Valsalva
Modified positional valsalva
Set-up
- 10ml syringe with plunger
- Two assistants - one to adjust head of bed and another to raise/lower legs.
Steps
- 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
- Quickly reposition patient's head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds
- Return head of bed to 45° and continue to monitor for resolution for 1 minute
- Repeat if needed
External Links
- Video explaination and demonstration of Modified Positional Valsalva
- The Lancet: REVERT Trial
- https://www.medmastery.com/magazine/modified-valsalva-maneuver-video-review