The Reverse Vagal Manoeuvre for SVT

Subscribe to Resus

Get the latest updates on our Conferences PLUS our Webcasts and Education Newsletters. And it's FREE!

  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Register Now:

Sorry, we couldn't find any posts. Please try a different search.

A NEW technique for reverting SVT was published in AJEM(1) this week. The Reverse Vagal manoeuvre for SVT, is simple and safe and in a limited case series, VERY effective.

SVT is not an uncommon patient presentation in the emergency department. In many cases the patient has had SVT before and knows what is happening. However there is no simple way for them to revert to sinus rhythm. This new reverse vagal manoeuvre for SVT, is something that the patient can easily learn and perform.

Previously we have discussed the REVERT trial where positive Valsalva via a syringe, plus a manoeuvre of lifting the legs was used ie., several assistants who know what they are doing, are needed. This new technique is simple and can be performed by the patient with no need for syringes or leg lifting or anything else.

The Technique

A Valsalva manoeuvre is again used with the aim of increasing vagal tone and reversing the SVT. It takes about 10 seconds. There are 4 easy steps involved:

  1. Fully exhale, but not forcefully
  2. Pinch you nose and close your mouth tightly
  3. Try and inhale against closed nose and mouth for 10 seconds, without swallowing
  4. Release

What they did

  • This is a case series of 11 patients
  • 10 of the 11 cases reverted(91%), and in some cases other vagal manoeuvres had not worked.

What’s next?

We certainly need a randomised trial next, however I can’t see any harm in trying this procedure now, as long as we take all the necessary precautions of having the patient in bed etc.,, so they don’t have a vaso-vagal and fall and injure themselves.

I’ve used the technique and it has worked very well.


  1. Gaudart P et al. The reverse vagal manoeuvre: A new tool for treatment of supra ventricular tachycardia? Am J Emerg Med. 2021 Mar;41:66-69.
Posted in ,

Dr Peter Kas

Emergency Physician, Educator. Key Interests: Resuscitation, Airway, Emergency Cardiology, Clinical Examination. Creator


  1. ykgekmsoj on 04/09/2021 at 6:45 pm

    The Reverse Vagal Manoeuvre for SVT – Resus

  2. Kyle on 07/10/2021 at 12:00 pm

    If some one wants to be updated with most recent technologies therefore he must be visit this website and
    be up to date every day.

  3. williams sonoma capitalone com activate on 12/10/2021 at 4:09 pm

    I know this if off topic but I’m looking into starting my own blog and was curious what all is needed to get setup? I’m assuming having a blog like yours would cost a pretty penny? I’m not very web savvy so I’m not 100 certain. Any suggestions or advice would be greatly appreciated. Many thanks

Leave a Comment