Valsalva Manoeuver and Atrial Fibrillation

How do vagal maneuvers work? Simply put, they affect the vagus nerve, a long nerve that runs from your brain to your belly. It sends signals to the atrioventricular node, a cluster of cells at the bottom of your heart’s upper right chamber that helps control your heartbeat. Think of it as an electrical relay station. It takes signals from the sinoatrial node and slows them down before passing them along to the lower chambers. The result: A slower heart rate.

Types of Vagal Maneuvers

  1. Valsalva maneuver. Hold your nose, close your mouth, and try to blow the air out. This creates pressure in your chest that may activate the vagus nerve. Sitting or squatting may help. Try it for 10 seconds.
  2. Cough. You need to cough hard to generate pressure in your chest and stimulate the vagus nerve. Children with tachycardia may not be able to cough hard enough to get a response from the vagus nerve.
  3. Gag.  You can try it with a finger. You doctor might use a tongue depressor.
  4. Hold your knees against your chest: Do it for a minute. This may work best for babies and children.
  5. Cold water treatment. You might hear this called the diving reflex.  You may need to put a plastic bag of ice on your face for 15 seconds. Or you can immerse your face in icy cold water for several seconds. It might also work to step into a cold shower or a cold bath.
  6. Carotid sinus massage: Only a doctor should perform this one: Lie down and stick out your chin. The doctor will put pressure on your carotid sinus, a bundle of nerves surrounding the carotid artery in your neck just below your jaw. You’ll be monitored during the procedure.

Web MD: Vagal Maneuvers to Slow Heart Rate

 

Overall, the Valsalva Manoeuver  appears to be a simple, non-invasive method of stopping abnormal heart rhythm, but its safety and overall effectiveness are difficult to quantify.

The effectiveness of the Valsalva Manoeuvre for stopping an abnormal heart rhythm