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. Log in via OpenAthens.

Carotid massage for svt

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. For instance, if the patient has supraventricular tachycardia and is unstable, VM may delay definitive treatment such as cardioversion. Some potential complications include dizziness and an arrhythmia originating in the ventricles. Most patients can easily be taught how to perform VM and they can be done almost anywhere. If a physician ensures a patient is an appropriate candidate for VM, the patient can be instructed to perform maneuvers at home in some situations. The management of SVT using vagal maneuvers has relied on a centuries-old procedure, which has undergone only minor modification over time. The identification of specific types of nodal re-entrant tachycardia may, with further research, identify which supraventricular tachycardia rhythm may best revert using VM in the early stages of arrhythmia.

All Rights Reserved. Forgot your user name or password?

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.

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.

Carotid massage for svt

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. An EP study is mostly used to diagnose some specific types of tachycardias and irregular heartbeats. During this test, a doctor guides one or more flexible tubes through a blood vessel, usually in the groin, to various areas in the heart.

Renville county jail phone number

During massage the patient had an immediate cerebrovascular accident, resulting in a left hemiplegia. Eighty-six underwent CSM first with conversion in 9 success rate Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia According to television, if there's a heart problem, you shock it, right? The difference was not statistically significant. Methods: This prospective, randomized case study was performed in the ED of a tertiary care institution. The management of SVT using vagal maneuvers has relied on a centuries-old procedure, which has undergone only minor modification over time. The use of vagal stimulation to halt supraventricular tachycardia is a standard medical therapy. Patient consent: Obtained. The only reported complication of the Valsalva maneuver is hypotension from straining. This content is owned by the AAFP. A year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. You will be able to get a quick price and instant permission to reuse the content in many different ways. Vagal Maneuvers with Supraventricular Tachycardia Vagal maneuvers are used as a first-line management tool with supraventricular tachycardia. Latest content Current issue Archive Authors About.

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.

Article menu. If there was no recurrence during the observation period, the patient was discharged with an outpatient appointment. The success rate as the initial vagal technique was Carotid sinus massage: is it a safe way to terminate supraventricular tachycardia? It is essential to understand that it is not always appropriate to have a patient attempt VM. Learn how this tool can and should be used. If the tachycardia was not terminated by the first method of vagal stimulation, the alternative maneuver was attempted. Supraventricular tachycardia SVT is a common heart abnormality that presents as a fast heart rate. Footnotes Competing interests: None. More in AFP. Forgot your log in details?