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.

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. During massage the patient had an immediate cerebrovascular accident, resulting in a left hemiplegia. Given the prevalence of atherosclerotic vascular disease in the general population and the safe alternatives available, it is recommended that CSM not be used for the termination of narrow complex tachycardia in the elderly population. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content.

Carotid massage for svt

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. Conversion occurred in 7 cases success rate For the 77 cases of SVT in which initial CSM did not achieve conversion, conversion occurred in 13 with the Valsalva maneuver success rate Conclusion: Vagal maneuvers are efficacious in terminating about one quarter of spontaneous SVT cases.

A person viewing it online may make one printout of the material and may use that printout only for his carotid massage for svt her personal, non-commercial reference. It is essential to understand that it is not always appropriate to have a patient attempt VM.

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.

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. This test helps show where faulty heart signals start in the heart.

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. A carotid massage, often called a carotid sinus massage or CSM, is a medical maneuver used to slow down a dangerously rapid heartbeat in patients or to diagnose certain heart rhythm disturbances. The carotid artery carries blood to the brain, and an incorrectly performed CSM can cause serious health repercussions, especially in elderly patients. Do not perform this maneuver on yourself or another person unless you are a physician.

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Results: One hundred forty-eight instances of SVT were studied Sixty-two patients underwent Valsalva maneuver first with conversion in 12 success rate of Patients with regular narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. This occurs through increased intrathoracic pressure leading to baroreceptor stimulation, as demonstrated through the heart rate and blood pressure responses. Most patients can easily be taught how to perform VM and they can be done almost anywhere. During massage the patient had an immediate cerebrovascular accident, resulting in a left hemiplegia. Log in via OpenAthens. You will be able to get a quick price and instant permission to reuse the content in many different ways. 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. All Rights Reserved. Continue Reading.

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.

You will be able to get a quick price and instant permission to reuse the content in many different ways. The difference was not statistically significant. All Rights Reserved. Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. Lim and associates compared the success rates of these two methods of vagal stimulation in terminating spontaneous supraventricular tachycardia in an emergency department setting. You are here Home Archive Volume 26, Issue 6 Carotid sinus massage: is it a safe way to terminate supraventricular tachycardia? Skip to main content. Log in using your username and password For personal accounts OR managers of institutional accounts. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Two methods of vagal stimulation, the Valsalva maneuver and carotid sinus massage, have been used in urgent situations. The success rate as the initial vagal technique was Emergency casebooks. Advanced search. Results: One hundred forty-eight instances of SVT were studied Sixty-two patients underwent Valsalva maneuver first with conversion in 12 success rate of This acts to prolong refractoriness of the nodal tissue and disrupt the re-entry circuit.