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The following is a summary of “Combined modified Valsalva maneuver with adenosine supraventricular tachycardia: A comparative study,” published in the April 2024 issue of Emergency Medicine by Xiao, et al.

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia encountered in emergency settings. Initial treatment options typically include modified Valsalva maneuver (MVM) and intravenous adenosine, each with success rates and risks. Combining these therapies may offer improved efficacy in terminating PSVT episodes. For a study, researchers sought to assess the success rate and potential risks associated with combining intravenous adenosine with MVM to treat PSVT.

Patients diagnosed with PSVT between 2017 and 2022 were enrolled and randomly allocated into three groups: the MVM, the intravenous adenosine, and the combination therapy group. The combination group underwent MVM twice and received intravenous adenosine administered in a titration manner up to three times. Success rates and side effects were recorded for each group.

The success rates for the MVM, adenosine, and combination groups were 42.11%, 75.00%, and 86.11%, respectively. The adenosine and combination groups demonstrated significantly higher success rates than the MVM groups (P < 0.01, P < 0.001). Although the combination group exhibited a higher success rate than the adenosine group, the difference was insignificant (P = 0.340). Regarding safety, the longest RR durations (asystole periods) were 1.61s, 1.60s, and 2.27s, with a statistical difference observed among the three groups (P < 0.01) and between the adenosine and combination groups (P = 0.018).

Combination therapy with intravenous adenosine and MVM demonstrated a relatively high success rate and favorable safety profile. However, the study did not establish the superiority of combination therapy over adenosine alone in terminating PSVT episodes.

Reference: sciencedirect.com/science/article/pii/S0735675724000366