Carotid massage for svt

The first explanation behind the process of using a Valsalva Maneuver was described in by Hamilton et al.

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.

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. Lim and associates compared the success rates of these two methods of vagal stimulation in terminating spontaneous supraventricular tachycardia in an emergency department setting. All patients with supraventricular tachycardia whose rhythm did not reveal obvious atrial flutter, atrial fibrillation or sinus tachycardia and who were hemodynamically stable were randomly assigned to undergo either the Valsalva maneuver or carotid sinus massage. Those who had carotid sinus massage were further randomized to undergo either right or left carotid sinus massage first. If the tachycardia was not terminated by the first method of vagal stimulation, the alternative maneuver was attempted. The Valsalva maneuver was performed by blowing into a mouthpiece with sustained resistance for 30 seconds or more. Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. If both methods of vagal stimulation failed, patients were managed with pharmacotherapy or cardioversion. All patients in whom rhythm conversion occurred were monitored by continuous electrocardiography for an additional two hours. If there was no recurrence during the observation period, the patient was discharged with an outpatient appointment.

Vagal maneuvers are used as a first-line management tool with supraventricular tachycardia. Carotid sinus massage was used in the 50 cases of SVT in which conversion was not achieved with the Valsalva maneuver.

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.

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. National Institutes of Health Go to source.

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.

Is there wifi on greyhound buses

Carotid sinus massage: is it a safe way to terminate supraventricular tachycardia? Emergency casebooks. According to television, if there's a heart problem, you shock it, right? Learn how this tool can and should be used. Register a new account? Patients with regular narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. If the tachycardia was not terminated by the first method of vagal stimulation, the alternative maneuver was attempted. 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. If there was no recurrence during the observation period, the patient was discharged with an outpatient appointment. These conductive accessory pathways pass through the atrioventricular septum and thus provide for a larger re-entry circuit, albeit one that passes through the AV node and is similarly affected by increased vagal tone. The success rate with right carotid sinus massage was the same as that for left carotid sinus massage. Lim SH, et al.

To diagnose supraventricular tachycardia SVT , a healthcare professional examines you and listens to your heart.

Carotid sinus massage was performed in the standard manner for 10 seconds with the head tilted to the opposite side. It is essential to understand that it is not always appropriate to have a patient attempt VM. Register a new account? Instant Provider Card. All patients with supraventricular tachycardia whose rhythm did not reveal obvious atrial flutter, atrial fibrillation or sinus tachycardia and who were hemodynamically stable were randomly assigned to undergo either the Valsalva maneuver or carotid sinus massage. 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. Emergency casebooks. Some evidence indicates that the Valsalva maneuver is more efficacious in men and that carotid sinus massage is more efficacious in older patients. All patients in whom rhythm conversion occurred were monitored by continuous electrocardiography for an additional two hours.