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Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial.
Am J Emerg Med. 2017 Nov; 35(11):1662-1665.AJ

Abstract

PURPOSE

The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT).

METHODOLOGY

This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients. In both groups; the determined procedure for standard or modified VM was repeated up to three times in patients whose PSVT did not convert to sinus rhythm. In both groups; if the maneuver was unsuccessful after three attempts, anti-arrhythmic medication was administered. The primary outcome was defined to compare the success rate of achieving sinus rhythm after standard VM or modified VM.

RESULTS

Fifty-six patients were randomized to modified or standard VM with 28 patients in each treatment arm. Three of 28 patients (10.7%) in VM group and 12 of 28 patients (42.9%) in modified VM group were returned to sinus rhythm after intervention (p=0.007). The number of patients who needed rescue treatment was lower in the modified VM group - 16 (57.1%) of 28 versus 25 (89.3%) of 28 in the standard VM group (p=0.007).

CONCLUSION

This study suggests that modified VM therapy was more effective than standard VM for terminating PSVT. The modified VM therapy also indirectly reduced the need for anti-arrhythmic medication and indirectly caused fewer side effects.

Authors+Show Affiliations

Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey. Electronic address: keremserefcorbacioglu@gmail.com.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.Kecioren Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28552271

Citation

Çorbacıoğlu, Şeref Kerem, et al. "Comparing the Success Rates of Standard and Modified Valsalva Maneuvers to Terminate PSVT: a Randomized Controlled Trial." The American Journal of Emergency Medicine, vol. 35, no. 11, 2017, pp. 1662-1665.
Çorbacıoğlu ŞK, Akıncı E, Çevik Y, et al. Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial. Am J Emerg Med. 2017;35(11):1662-1665.
Çorbacıoğlu, Ş. K., Akıncı, E., Çevik, Y., Aytar, H., Öncül, M. V., Akkan, S., & Uzunosmanoğlu, H. (2017). Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial. The American Journal of Emergency Medicine, 35(11), 1662-1665. https://doi.org/10.1016/j.ajem.2017.05.034
Çorbacıoğlu ŞK, et al. Comparing the Success Rates of Standard and Modified Valsalva Maneuvers to Terminate PSVT: a Randomized Controlled Trial. Am J Emerg Med. 2017;35(11):1662-1665. PubMed PMID: 28552271.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing the success rates of standard and modified Valsalva maneuvers to terminate PSVT: A randomized controlled trial. AU - Çorbacıoğlu,Şeref Kerem, AU - Akıncı,Emine, AU - Çevik,Yunsur, AU - Aytar,Halit, AU - Öncül,Mehmet Veysel, AU - Akkan,Sedat, AU - Uzunosmanoğlu,Hüseyin, Y1 - 2017/05/22/ PY - 2017/04/15/received PY - 2017/05/15/revised PY - 2017/05/22/accepted PY - 2017/5/30/pubmed PY - 2017/11/7/medline PY - 2017/5/30/entrez KW - Emergency department KW - Modified Valsalva maneuver KW - Standard Valsalva maneuver KW - Supraventricular tachycardia SP - 1662 EP - 1665 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 35 IS - 11 N2 - PURPOSE: The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). METHODOLOGY: This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients. In both groups; the determined procedure for standard or modified VM was repeated up to three times in patients whose PSVT did not convert to sinus rhythm. In both groups; if the maneuver was unsuccessful after three attempts, anti-arrhythmic medication was administered. The primary outcome was defined to compare the success rate of achieving sinus rhythm after standard VM or modified VM. RESULTS: Fifty-six patients were randomized to modified or standard VM with 28 patients in each treatment arm. Three of 28 patients (10.7%) in VM group and 12 of 28 patients (42.9%) in modified VM group were returned to sinus rhythm after intervention (p=0.007). The number of patients who needed rescue treatment was lower in the modified VM group - 16 (57.1%) of 28 versus 25 (89.3%) of 28 in the standard VM group (p=0.007). CONCLUSION: This study suggests that modified VM therapy was more effective than standard VM for terminating PSVT. The modified VM therapy also indirectly reduced the need for anti-arrhythmic medication and indirectly caused fewer side effects. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/28552271/Comparing_the_success_rates_of_standard_and_modified_Valsalva_maneuvers_to_terminate_PSVT:_A_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(17)30415-1 DB - PRIME DP - Unbound Medicine ER -