A CROSS SECTIONAL STUDY TO ASSESS THE EFFICACY OF VALVSALVA MANEUVER FOR THE EMERGENCY MANAGEMENT OF SUPRAVENTRICULAR TACHYCARDIA

Abstract

Background: Supraventricular tachycardia (SVT) is a common arrhythmia presenting in emergency settings and is characterized by rapid atrial activity leading to palpitations, chest pain, and hemodynamic compromise. Restoring sinus rhythm is a primary goal in acute management and can be achieved through pharmacological agents, electrical cardioversion, or vagal maneuvers. Among these, the Valsalva maneuver (VM) is a non-invasive, low-cost, and widely used technique. Despite its established use globally, limited data exist regarding its efficacy in local emergency care contexts, warranting further evaluation.

Objective: To determine the efficacy of the Valsalva maneuver in the emergency management of supraventricular tachycardia.

Methods: This cross-sectional study was conducted in the Department of Emergency Medicine, CMH Rawalpindi, from 15th April 2022 to 14th April 2024. A total of 192 patients aged 20–70 years, both male and female, with SVT confirmed on ECG were enrolled using non-probability consecutive sampling. Patients with myocardial infarction, aortic stenosis, pregnancy, retinopathy, raised intraocular pressure, or severe cardiopulmonary compromise were excluded. Standard and modified forms of the VM were performed under continuous ECG and vital monitoring. Efficacy was defined as reversion to sinus rhythm with a heart rate <110 beats per minute within one minute of the maneuver. Data were analyzed using SPSS version 24, applying chi-square and t-tests with p ≤ 0.05 considered significant.

Results: The mean age of patients was 48.52 ± 10.70 years in the standard group (n = 124) and 50.15 ± 9.69 years in the modified group (n = 68). Males comprised 51.6% of the standard group and 72.1% of the modified group. Overall efficacy of VM was 32.3% (n = 62). Standard VM was effective in 38.7% (n = 48) compared with 20.6% (n = 14) in the modified group (p = 0.010). Mean stay in the emergency room was 3.16 ± 1.84 days versus 3.07 ± 1.42 days in the two groups (p = 0.733).

Conclusion: The Valsalva maneuver was effective in terminating SVT and restoring sinus rhythm. Its simplicity, safety, and cost-effectiveness make it a valuable first-line intervention in emergency settings, particularly in resource-limited environments.