Modified valsalva manoeuvre

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The proven modified valsalva manoeuvre for terminating a supraventricular tachycardia (SVT) involves[1]:

  • Subject lies down (semi-recumbant at 45°)
  • Ideally strain of 40mmHg (pressure required to move a 10ml syringe plunger)
  • Immediately after strain laid flat
  • Legs raised to 45° for 15 seconds
  • Repeat if 1 minute ECG not cardiverted

This produces cardioversion in 43% compared to 17% with traditional valsalva