Vagus, Baby!

Some are safer — and more reliable and practical — than others:

Diving Reflex, Inverted Position, Carotid Massage, Valsalva and Modified Valsalva Maneuvers…

Selected References

Appelboam A et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015 Oct 31;386(10005):1747-53. doi: 10.1016/S0140-6736(15)61485-4. Epub 2015 Aug 24.

Arnold RW. The human heart rate response profiles to five vagal maneuvers. Yale J Biol Med. Jul-Aug 1999;72(4):237-44.

Bronzetti G et al. Upside-down position for the out of hospital management of children with supraventricular tachycardia. International Journal of Cardiology 2018 February 1, 252: 106-109

Campbell M et al. BET 2: Ice water immersion, other vagal manoeuvres or adenosine for SVT in children. Emerg Med J. 2017 Jan;34(1):58-60. doi: 10.1136/emermed-2016-206487.2.

Chamsi-Pasha MAR. Avicenna’s contribution to cardiology. Avicenna J Med. 2014 Jan;4(1):9-12. doi: 10.4103/2231-0770.127415.

Collins NA et al. Reconsidering the effectiveness and safety of carotid sinus massage as a therapeutic intervention in patients with supraventricular tachycardia. Am J Emerg Med. 2015 Jun;33(6):807-9. doi: 10.1016/j.ajem.2015.02.047. Epub 2015 Mar 7.

Fisher JP et al. Diving and exercise: the interaction of trigeminal receptors and muscle metaboreceptors on muscle sympathetic nerve activity in humans. Am J Physiol Heart Circ Physiol. 2015 Mar 1;308(5):H367-75. doi: 10.1152/ajpheart.00728.2014. Epub 2014 Dec 19.

Hare M et al. Handstands: a treatment for supraventricular tachycardia? Arch Dis Child. 2015 Jan;100(1):54-5. doi: 10.1136/archdischild-2014-306949. Epub 2014 Oct 14.

Olshansky B et al. Evaluation of the Patient with Suspected Arrhythmias. Arrhythmia Essentials (Second Edition) 2017, Elsevier. Pages 347-356.

Pstras L et al. The Valsalva manoeuvre: physiology and clinical examples. Acta Physiol (Oxf). 2016 Jun;217(2):103-19. doi: 10.1111/apha.12639. Epub 2016 Jan 5.

Smith G, Morgans A, Taylor DM, Cameron P. Use of the human dive reflex for the management of supraventricular tachycardia: a review of the literature. Emerg Med J. 2012 Aug;29(8):611-6. doi: 10.1136/emermed-2011-200877. Epub 2012 Mar 3. PMID: 22389355.