Effectiveness of the Valsalva Manoeuvre for reversion of supraventricular tachycardia

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Summary of findings for the main comparison. Summary of findings ‐ induced SVT

Valsalva Manoeuvre for induced supraventricular tachycardia
Patient or population: People with induced SVT Settings: Clinical laboratory Intervention: VM Comparison: Nil
Outcomes	Study	VM Performance (posture, strain duration, pressure)	Reversion n (%)	Quality of the evidence (GRADE)
Reversion	Mehta 1988	Supine, 15 and 30 seconds*, 35 mmHg	19/35 (54.3)	⊕⊕⊝⊝ low
Reversion	Wen 1998	Supine, 30 seconds, 35 mmHg	61/133 (45.9)	⊕⊕⊝⊝ low
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. *Although applying both 15‐ and 30‐second strain durations, the Mehta study found no statistical significance of bradycardia effect (increased vagal tone) on participants when assessed in sinus rhythm.
Abbreviations: SVT: supraventricular tachycardia VM: Valsalva Manoeuvre

Summary of findings for the main comparison. Summary of findings ‐ induced SVT

Summary of findings 2. Summary of findings ‐ clinical SVT

Valsalva Manoeuvre for clinical supraventricular tachycardia (patients presenting with arrhythmia)
Patient or population: Patients presenting to emergency department with SVT Settings: Emergency department (hospital) Intervention: VM Comparison: Nil
Outcomes	Study	VM Performance (posture, strain duration, pressure)	Reversion n (%)	Quality of the evidence (GRADE)
Reversion	Lim 1998	Sitting*, 30 seconds, 40 mmHg	12/62 (19.4)	⊕⊕⊝⊝ low
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. *Although a deviation from accepted standard of performance technique, this posture is acceptable as a known method of performance in the clinical setting. Also, this posture has been demonstrated to precipitate adverse effects. The absence of reported adverse effects (such as hypotension or syncope) is not clear within the study.
Abbreviations: SVT: supraventricular tachycardia VM: Valsalva Manoeuvre

Summary of findings 2. Summary of findings ‐ clinical SVT

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