REVERT for SVT

Improve success of vagal maneuvers for patients in simple SVT by adding the “REVERT” maneuver: the patient performs valsalva maneuver in a semi-recumbent position, then the practitioner immediately puts the patient into a supine position with legs passively raised at a 45 degree angle. This maneuver improved conversion to NSR at 1 minute from 17% to 43%, for a NNT of 3.8. A simple way to have a patient perform a valsalva maneuver is to blow on the tip of a 10cc syringe hard enough to move the plunger. For an excellent discussion of the trial and a video of the maneuver see http://rebelem.com/the-revert-trial-a-modified-valsalva-maneuver-to-convert-svt/