Improved Valsalva manoeuvre keeps SVT patients out of hospital

Patients with supraventricular tachycardia (SVT) should be taught a simple modification to the Valsalva manoeuvre that makes it much more effective in cardioversion and will keep them out of hospital, emergency medicine specialists say.

Getting patients to lie supine and raise their legs after performing the Valsalva manoeuvre improves its success rate from as low as 5% to almost 50%, a trial carried out in EDs in UK hospitals has shown.

The simple modification was tested in a randomised trial of 428 patients with SVT.

Success rates in achieving immediate restoration of