ReviewInternal and emergency medicine2026
Effectiveness of the modified Valsalva maneuver vs the standard Valsalva maneuver for the conversion of supraventricular tachycardia to normal sinus rhythm in the emergency department: a systematic review and meta analysis.
Review in Internal and emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
Funding
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Abstract
Supraventricular tachycardia (SVT) is a cardiac arrhythmia that is commonly encountered in the emergency department (ED), for which vagal maneuvers represent first-line treatment in hemodynamically stable patients. The modified Valsalva maneuver (MVM), which involves supine repositionings and leg raises that follow the strain phase, have been proposed as a more effective alternative to the standard Valsalva maneuver (SVM). We performed a systematic review and meta-analysis (SRMA) of randomized controlled trials comparing the MVM to the SVM for conversion of SVT to normal sinus rhythm in hemodynamically stable patients presenting to the ED. PubMed, Web of Science, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched from inception through March 17, 2026. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and dichotomous outcomes were pooled as risk ratios (RR) with 95% confidence intervals (CIs). Nine trials comprising 1415 patients were included. The MVM achieved successful cardioversion in 50.1% of patients compared with 18.8% in the SVM group (polled RR 2.63, 95% CI 2.22-3.11; I
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