Carotid massage for svt

A year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. Carotid sinus massage CSM was performed to help identify the underlying rhythm.

The first explanation behind the process of using a Valsalva Maneuver was described in by Hamilton et al. The pathophysiological basis of action of the four phases of the maneuver is based on the nature of increased refractoriness of AV nodal tissue, particularly on the effect of vagal activity. This occurs through increased intrathoracic pressure leading to baroreceptor stimulation, as demonstrated through the heart rate and blood pressure responses. The best available evidence currently, specifically the work of Taylor and Wong , supports the following three criteria in an evidence-based model of practice of the Valsalva Maneuver for SVT reversion in the emergency-care setting:. Patients should be instructed how to perform VM properly before attempting one. In addition, carotid massage is only recommended for select patients and may only be performed by a physician. It is essential to understand that it is not always appropriate to have a patient attempt VM.

Carotid massage for svt

The use of vagal stimulation to halt supraventricular tachycardia is a standard medical therapy. Two methods of vagal stimulation, the Valsalva maneuver and carotid sinus massage, have been used in urgent situations. Lim and associates compared the success rates of these two methods of vagal stimulation in terminating spontaneous supraventricular tachycardia in an emergency department setting. All patients with supraventricular tachycardia whose rhythm did not reveal obvious atrial flutter, atrial fibrillation or sinus tachycardia and who were hemodynamically stable were randomly assigned to undergo either the Valsalva maneuver or carotid sinus massage. Those who had carotid sinus massage were further randomized to undergo either right or left carotid sinus massage first. If the tachycardia was not terminated by the first method of vagal stimulation, the alternative maneuver was attempted. The Valsalva maneuver was performed by blowing into a mouthpiece with sustained resistance for 30 seconds or more. Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. If both methods of vagal stimulation failed, patients were managed with pharmacotherapy or cardioversion. All patients in whom rhythm conversion occurred were monitored by continuous electrocardiography for an additional two hours. If there was no recurrence during the observation period, the patient was discharged with an outpatient appointment.

Lim SH, et al.

Methods: This prospective, randomized case study was performed in the ED of a tertiary care institution. Patients with regular narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. If the tachycardia was not terminated by the method chosen by randomization, then the alternative method of vagal maneuver was used. If the tachycardia was not converted by both methods of vagal stimulation, patients would undergo either synchronized electrical cardioversion or a pharmacologic method of conversion at the discretion of the treating physician, depending on the patient's hemodynamic status. Results: One hundred forty-eight instances of SVT were studied Sixty-two patients underwent Valsalva maneuver first with conversion in 12 success rate of Eighty-six underwent CSM first with conversion in 9 success rate Carotid sinus massage was used in the 50 cases of SVT in which conversion was not achieved with the Valsalva maneuver.

To diagnose supraventricular tachycardia SVT , a healthcare professional examines you and listens to your heart. A member of your care team takes your blood pressure. You are usually asked questions about your symptoms, health habits and medical history. Other tests that may be done to diagnose SVT include:. Electrophysiological EP study.

Carotid massage for svt

Last Updated: September 16, Fact Checked. This article was medically reviewed by Jennifer Boidy, RN. Jennifer Boidy is a Registered Nurse in Maryland. There are 9 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 99, times.

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If the tachycardia was not terminated by the first method of vagal stimulation, the alternative maneuver was attempted. More in AFP. January ; A year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. Learn how this tool can and should be used. The fast pathway inputs near the compact AV node, and the slow pathway inputs near the os of the coronary sinus. Patients should be instructed how to perform VM properly before attempting one. Eighty-six underwent CSM first with conversion in 9 success rate For instance, if the patient has supraventricular tachycardia and is unstable, VM may delay definitive treatment such as cardioversion. SVT is a generic term applied to any tachycardia originating above the ventricles and which involves atrial tissue or atrioventricular AV nodal tissue. In addition, carotid massage is only recommended for select patients and may only be performed by a physician. Log in via OpenAthens.

The first explanation behind the process of using a Valsalva Maneuver was described in by Hamilton et al. The pathophysiological basis of action of the four phases of the maneuver is based on the nature of increased refractoriness of AV nodal tissue, particularly on the effect of vagal activity.

Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. VM involve different techniques used to stimulate aortic baroreceptors located within the walls of the aortic arch and within the carotid bodies. The Valsalva maneuver was performed by blowing into a mouthpiece with sustained resistance for 30 seconds or more. According to television, if there's a heart problem, you shock it, right? Some potential complications include dizziness and an arrhythmia originating in the ventricles. SVT is a generic term applied to any tachycardia originating above the ventricles and which involves atrial tissue or atrioventricular AV nodal tissue. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Abstract A year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. Log in. The authors conclude that vagal maneuvers are safe and efficacious in ending about 25 percent of spontaneous supraventricular tachycardias if performed properly. Forgot your log in details? The only reported complication of the Valsalva maneuver is hypotension from straining.