Modified positional valsalva: Difference between revisions

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==Background==
==Background==
===2015 [[REVERT Trial]]===
===2015 REVERT Trial===
*Found for [[SVT]] resolution to [[NSR]]:<ref>Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial [http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2961485-4.pdf fulltext]</ref>
*Studied modified Valsalva for [[SVT]] conversion to normal sinus:<ref>Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial [http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2961485-4.pdf fulltext]</ref>
**Normal Valsalva - 17% resolution  
**Normal Valsalva - 17% resolution  
**Modified Positional Valsalva - '''43% resolution'''  
**Modified Positional Valsalva - '''43% resolution'''  
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{{Modified positional valsalva}}
{{Modified positional valsalva}}


==Links==
==External Links==
*[https://www.youtube.com/watch?v=8DIRiOA_OsA Video explaination and demonstration of Modified Positional Valsalva]
*[https://www.youtube.com/watch?v=8DIRiOA_OsA Video explaination and demonstration of Modified Positional Valsalva]
*[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61485-4/abstract The Lancet: REVERT Trial]
*[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61485-4/abstract The Lancet: REVERT Trial]
*https://www.medmastery.com/magazine/modified-valsalva-maneuver-video-review


==See Also==  
==See Also==  
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==References==
==References==
<references />
<references />


[[Category:Cardiology]]
[[Category:Cardiology]]

Latest revision as of 04:46, 21 August 2019

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

Screen Shot 2016-08-04 at 6.14.06 PM.png
Screen Shot 2016-08-04 at 5.53.13 PM.png
  • 10ml syringe with plunger
  • Two assistants - one to adjust head of bed and another to raise/lower legs.

Steps

  1. Position patient with legs flat and head of bed to 45°
  2. Have patient attempt to blow out plunger of 10ml syringe (or Valsalva around 40mmHg) for 15 seconds
  3. Quickly reposition patient's head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds
  4. Return head of bed to 45° and continue to monitor for resolution for 1 minute
  5. Repeat if needed

External Links

See Also

References

  1. Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial fulltext