Modified Valsalva manoeuvre effectively treats supraventricular tachycardia in adults

The primary outcome was the reconversion to a sinus rhythm. Secondary outcomes included medication use, adverse events, length of stay in the emergency department and hospital admission.

Five randomised controlled trials were included, with a combined total of 1181 participants. The meta-analysis demonstrated a significantly higher success rate for reconversion to sinus rhythm when using the modified Valsalva manoeuvre compared to the standard Valsalva manoeuvre in patients with an supraventricular tachycardia. More adverse events were reported in the modified Valsalva manoeuvre group, although this difference is NS.

The available evidence suggests that medication use was lower in the modified Valsalva manoeuvre group than the standard Valsalva manoeuvre group. However, medication use could not be generalised across the different studies.

None of the included studies showed a significant difference in length of stay in the emergency department. Only one study reported on hospital admission, with no significant difference between the two groups.

The authors concluded that the available evidence is highly suggestive to support the use of the modified Valsalva manoeuvre compared to the standard Valsalva manoeuvre in the treatment of adult patients with supraventricular tachycardia.

Furthermore, meta-analysis showed a higher success rate, required less medication use, and resulted in an equal number of adverse events. However, these results cannot be regarded as definitive in the absence of higher-quality studies.

doi: 10.1097/MEJ.0000000000000862