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The Modified Valsalva Maneuver for Reversion of Stable Supraventricular Tachycardia

Lessons Learned From the REVERT Trial

Davis, Wesley D. DNP, ENP-C, FNP-C, AGACNP-BC, CEN; Norris, Kimberly C. MSN, FNP-C; Fiebig, William MSN, ENP-C, FNP-C, AGACNP-BC, CEN, NREMT-P

Section Editor(s): Evans, Dian Dowling PhD, FNP-BC, ENP-C, FAANP, FAAN; Column Editor

doi: 10.1097/TME.0000000000000252

The REVERT trial was a randomized multicenter trial that investigated the efficacy of using a modified Valsalva maneuver for the reversion of stable supraventricular tachycardia back to a sinus rhythm. Although no improvement in discharge to home from the emergency department (ED) or ED length of stay was observed, the REVERT trial demonstrated that the modified Valsalva maneuver was superior to the standard Valsalva maneuver. The modified Valsalva maneuver should be considered first-line treatment for patients who present with a stable supraventricular tachycardia. A case presentation illustrates the methodology for utilizing the modified Valsalva maneuver to treat supraventricular tachycardia in a hemodynamically stable patient who presents to the ED.

College of Nursing, University of South Alabama, Mobile (Dr Davis, Ms Norris, and Mr Fiebig); and Crook County Medical Services District, Sundance, Wyoming (Dr Davis).

Corresponding Author: Wesley D. Davis, DNP, ENP-C, FNP-C, AGACNP-BC, CEN, College of Nursing, University of South Alabama, 5721 USA Dr, North, Mobile, AL 36688 (

Disclosure: The authors report no conflicts of interest.

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