Vagal Maneuver

Excerpt

Vagal maneuvers are techniques used to increase vagal parasympathetic tone in an attempt to diagnose and treat various arrhythmias. They are often utilized first in an effort to abort episodes of stable supraventricular tachycardia (SVT) or differentiate SVT from ventricular tachycardias (VT). Common vagal maneuvers include carotid sinus massage (CSM), Valsalva maneuver (VM), and diving reflex. Less commonly used maneuvers not discussed here include ocular pressure, stimulation of the gag reflex, applied abdominal pressure, and headstands. When utilized early in appropriately selected patients presenting with atrioventricular nodal re-entrant tachycardia (AVNRT), vagal maneuvers have a 20 to 40% success rate of conversion back to sinus rhythm, and potentially higher in atrioventricular re-entrant tachycardia (AVRT, or SVT associated with a bypass tract).