Vagal Maneuvers, a Unique Osteopathic Addition to the ACLS Armament: Review
Keywords:
Disease Management, Emergencies, Osteopathic Manipulation, Supraventricular Tachycardia
Abstract
In the United States, there are more than half a million people diagnosed with supraventricular tachycardia (SVT). There are approximately 89,000 new presentations of SVT a year, many of them presenting to U.S. emergency centers for initial management of their tachydysrhythmia. The purpose of this article is to describe the wide range of effective techniques for the initial non-pharmacologic management of supraventricular tachycardia, and to discuss their mechanisms of action and potential drawbacks. Additionally, we will introduce a commonly used Osteopathic Manipulative Therapy as a potential first-line treatment option for hemodynamically stable SVT.
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References
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2. Neumar RW, Otto CW, Link M, et al. Adult Advanced Cardiovascular Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov;122:S729-67. [PubMed]
3. Muller G, Deal B, Benson DW. “Vagal Maneuvers” and adenosine for termination of atrioventricular reentrant tachycardia. Am J Cardiol. 1994 Sept;1(74):500-3. [PubMed]
4..Smith GD, Fry MM, Taylor D, MorgansA, Cantwell K. Effectiveness of the valsalva maneuver for reversion of supraventricular tachycardia. Cochrane Database of Systematic Reviews. 2015 Feb;18(2).
6. Ganz LI, Friedman PL. Supraventricular tachycardia. N Engl J Med. 1995;(332):162-73. [PubMed]
7. Akhtar M, Jazayeri MR, Sra J, Blanck Z, Deshpande S, Dhala A. Atrioventricular nodal reentry: clinical, electrophysiological, and therapeutic considerations. Circulation. 1993; (88):282-95.
8. Lim S, Anantharaman V, Teo W, Goh P, Tan A. Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage.Annals of Emergency Medicine. January 1998; 31(1):30-35.
9. Taylor DM, Wong LF. Incorrect instruction in the use of the Valsalva maneuver for paroxysmal supra-ventricular tachycardia is common. Emerg Med Australas. 2004 Aug;16(4):284-7. [PubMed]
10. Porth CJ, Bamrah VS, Tristani FE, Smith JJ. The Valsalva maneuver: mechanisms and clinical implications. Heart Lung. 1984 Sep;13(5):507-18. [PubMed]
11. Junqueira, LF. Teaching cardiac autonomic function dynamics employing the Valsalva (Valsalva-Weber) maneuver. AdvPhysiol Educ. 2008 Mar; 32(1):100-6.
12. Smith G. Management of supraventricular tachycardia using the Valsalva maneuver: a historical review and summary of published evidence. Euro J Emerg Med. 2012 Dec;19(6):346-52.
13. Rothberger CJ, Winterberg H. UberdieBeziehungen der Herznervenzuratrioventrikularenautomatie (nodal rhythm). Arch Ges Physiol. 1910;(135) 559-604.
14. Martin,P. The Influence of the Parasympathetic Nervous System on Atrioventricular Conduction. Circulation Research. 1988;(41):593-9. [PubMed]
15. Waxman MB, Wald RB, Sharma AD, et al: Vagal techniques for termination of paroxysmal supraventricular tachycardia. Am J Cardiol. 1980;(46):655-64. [PubMed]
16. Ornato JP, Hallagan LF, Reese WA, et al. Treatment of paroxysmal supraventricular tachycardia in the emergency department by clinical decision analysis. Am J Emerg Med. 1988;(6):555-60.
17. Richardson DA, Bexton R, Shaw FE, Sten N, Bond J, Kenny RA. Complications of carotid sinus massage—a prospective study of older patients. Age and Ageing.2000;(29):413-7. [PubMed]
18. Matthews OA. Ventricular tachycardia induced by carotid sinus stimulation. J Maine Med Assoc. 1969;(60):135-6. [PubMed]
19. Askey JM. Monoplegia following carotid sinus massage.J Intern Med. 1994;(235):379-81. [PubMed]
20. Nishizaki M, Yamawake N, Arita M. Coronary artery spasm induced by carotid massage. Heart. 2000;(84): E2. [PubMed]
21. Finley JP, Bonet JF, Waxman MB. Autonomic pathways responsible for bradycardia on facial immersion. Journal of Applied Physiology.1979;(47):1218-22. [PubMed]
22. Aydin M, Baysal K, Kucukoduk S, Cetinkaya F, Yaman S. Application of ice water to the face in initial treatment of supraventricular tachycardia. Turk J Pediatr. 1995 Jan-Mar;37(1):15-7. [PubMed]
23. Arnold RW. The human heart rate response profiles to five vagal maneuvers.Yale Journal of Biology and Medicine.1999;(72): 237-44. [PubMed]
24. Yamashita M. Oculocardiac reflex and the anesthesiologist. Mideast J. Anesthesiology, 1986;(8):399-415. [PubMed]
25. Bolton EC. Dysrhythmias. Emergency Medicine: Concepts and Clinical Practice. St Louis, MO: CV Mosby CO, 1983. 887-916.
26. Silverman ME.Recognition and treatment of arrhythmias.Principles and Practice of Emergency Medicine. Philadelphia, PA: WB Saunders CO, 1978. 891-921. [PubMed]
27. Schwam E. The Eyes Have It. AcadEmerg Med. 2004 Aug 8;(11):842-3.
28. Roberge R, Anderson E, MacMath T, Rudoff J, Luten R. Termination of Paroxysmal Supraventricular Tachycardia by Digital Rectal Massage. Annals of Emergency Medicine. 1987;(16):139-41.
29. Adams RD, Victor M. Principles of Neurology, ed 2. New York, NY: McGraw-Hill, 1981. 363-83.
30. Dejong RN. The Neurologic Examination, ed 4. Philadelphia, PA: Harper and Row, 1979. 507.
31. Bosker G. The Emergency Medicine Reports textbook of adult and pediatric emergency medicine: principles, protocols, pathways. Atlanta, GA: American Health Consultants, 2002. 936.
32. Nicholas A, Nicholas E. Occipitomastoid Suture Pressure.Atlas of Osteopathic Techniques. 2008;(1):398.
CITATION
DOI: 10.17511/ijmrr.2015.i4.076
Published: 2015-05-31
How to Cite
1.
Pescatore II RM, N. Abo B, C. Ruppel M, M. Smolar J, M. Sklar R, A. Pulley S. Vagal Maneuvers, a Unique Osteopathic Addition to the ACLS Armament: Review. Int J Med Res Rev [Internet]. 2015May31 [cited 2024Dec.23];3(4):436-40. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/260
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Section
Review Article