Comparison of Treatment of Paroxysmal Supraventricular Tachycardia by Valsalva Manoeuver and Carotid Sinus Massage

Background: Paroxysmal supraventricular tachycardia (PSVT) is a rapid rhythm disturbance originating from the atria or atrioventricular node. This is the most common paroxysmal tachycardia presenting to emergency department and often seen without heart disease. Aim: To compare the efficacy of Valsalva maneuver (VM) with that of carotid sinus massage (CSM) in terminating PSVT in patients coming to emergency department. Methods: This randomized controlled trial was carried out in Emergency Department of Cardiac Complex, Gulab Devi Hospital, Lahore. One hundred patients who fulfilled the inclusion criteria were randomly divided into two groups by lottery method. Electocardiography (ECG) monitoring was done, intravenous line was secured and resuscitation tray was arranged. Group-A patients were treated with VM and Group-B patients with CSM. Procedure was considered effective if it converted PSVT to normal sinus rhythm in 10 minutes. Results: The mean age of the patients in group A was 40.1 +/- 13.1 years and in group B was 38.6 +/- 11.8 years. In Group-A, 30(60%) patients had efficacy of procedure and in group B, 18 (36%) patients had efficacy of procedure. Conclusion: VM achieved better clinical efficacy as compared to CSM in terminating PSVT.