Instructions for the Modified Valsalva Maneuver for Treatment of Supraventricular Tachycardia (SVT)



1) In a semi-recumbent position, have the patient blow into a 10cc syringe for 15 seconds, generating ~40 mmHg pressure (Standard Valsalva Maneuver)

2) Move patient to a supine position and perform a 15 second passive leg raise to an elevation of 45°

3) Return to semi-recumbent position for 30 seconds. 



Can repeat once if no success in cardioversion.



43% cardioversion in Modified Valsalva maneuver vs 17% cardioversion in standard Valsalva maneuver

REVERT Trial - Lancet 2015; 386: 1747–53 http://dx.doi.org/10.1016/S0140-6736(15)61485-4



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