MODIFIKASI MANUVER VALSALVA UNTUK KARDIOVERSI TAKIKARDIA SUPRAVENTRIKULAR DI DAERAH RURAL
DOI:
https://doi.org/10.23887/gm.v4i1.74069Keywords:
palpitasi, modifikasi manuver valsalva, takikardia supraventrikularAbstract
Takikardia supraventrikular adalah takiaritmia yang melibatkan jaringan atrium atau persimpangan atrioventrikular yang disertai dengan gejala klinis seperti palpitasi, sesak napas, atau bahkan tanpa gejala. Seorang wanita berusia 54 tahun dan seorang pria berusia 59 tahun datang ke UGD dengan keluhan berdebar tiba-tiba. Tidak ada aktivitas berat sebelumnya yang menjadi pemicu awal. Hasil EKG kedua pasien menunjukkan takikardia supraventrikular. Modifikasi Manuver Valsalva dilakukan pada kedua pasien, dan observasi selama 45-60 detik menunjukkan adanya pemulihan irama menjadi irama sinus. Modifikasi Manuver Valsalva bekerja dengan meningkatkan tonus vagal. Peningkatan tekanan intratoraks mencegah aliran balik vena perifer ke jantung kanan ketika pasien melakukan ekspirasi paksa. Ini akan mengaktivasi sistem saraf simpatis. Manuver Valsalva yang dimodifikasi telah menunjukkan bahwa tingkat keberhasilan konversi SVT dapat mencapai 43%, yang jauh lebih tinggi daripada Manuver Valsalva konvensional (17%) serta jauh lebih hemat biaya dan aman.
References
Appelboam A, Reuben A, Mann C, Gagg J, Ewings P, Barton A, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): A randomised controlled trial. Lancet [Internet]. 2015 Oct 31 [cited 2023 Dec 9];386(10005):1747–53. Available from: http://www.thelancet.com/article/S0140673615614854/fulltext
Mohammad A, Saeed M, Babylon FM-MJ of, 2019 undefined. Effectiveness of the modified valsalva maneuver in the emergency management of supraventricular tachycardia. iasj.netAM Mohammad, MS Saeed, F MiglioreMedical J Babylon, 2019•iasj.net [Internet]. 2019 [cited 2023 Dec 10]; Available from: https://www.iasj.net/iasj/download/05b35d0731972b26
Chen C, Tam TK, Sun S, Guo Y, Teng P, Jin D, et al. A multicenter randomized controlled trial of a modified Valsalva maneuver for cardioversion of supraventricular tachycardias. Am J Emerg Med. 2020 Jun 1;38(6):1077–81.
Michaud A, Lang E. Leg Lift Valsalva Maneuver for Treatment of Supraventricular Tachycardias. Can J Emerg Med [Internet]. 2017 May 1 [cited 2023 Dec 9];19(3):235–7. Available from: https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/leg-lift-valsalva-maneuver-for-treatment-of-supraventricular-tachycardias/3A114C51F15C131FD5A89F4D3ADC7464
Williams SE, O’Neill M, Kotadia ID. Supraventricular tachycardia: An overview of diagnosis and management. Clin Med (Northfield Il) [Internet]. 2020 [cited 2023 May 13];20(1):43. Available from: /pmc/articles/PMC6964177/
Helton MR. Diagnosis and Management of Common Types of Supraventricular Tachycardia. Am Fam Physician [Internet]. 2015 Nov 1 [cited 2023 May 13];92(9):793–802. Available from: https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html
Ibetoh CN, Stratulat E, Liu F, Wuni GY, Bahuva R, Shafiq MA, et al. Supraventricular Tachycardia in Pregnancy: Gestational and Labor Differences in Treatment. Cureus [Internet]. 2021 Oct 4 [cited 2023 May 13];13(10). Available from: /pmc/articles/PMC8494174/
Smith GD, Fry MM, Taylor D, Morgans A, Cantwell K. Effectiveness of the Valsalva Manoeuvre for reversion of supraventricular tachycardia. Cochrane Database Syst Rev [Internet]. 2015 Feb 18 [cited 2023 Dec 9];2015(2). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009502.pub3/full
Wang W, Han WZ, Jin L, Zhao XJ, Jiang TF, Guo Y. Efficacy and economic benefits of a modified Valsalva maneuver in patients with paroxysmal supraventricular tachycardia. World J Clin Cases [Internet]. 2020 Dec 12 [cited 2023 Dec 10];8(23):5999. Available from: /pmc/articles/PMC7723698/
Pandya A, Lang E. Valsalva maneuver for termination of supraventricular tachycardia. Ann Emerg Med [Internet]. 2015 Jan 1 [cited 2023 Dec 10];65(1):27–9. Available from: http://www.annemergmed.com/article/S0196064413006884/fulltext
Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomstrom-Lundqvist C, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 2020 Feb 1;41(5):655–720.
Al-Khatib SM, Arshad A, Balk EM, Das SR, Hsu JC, Joglar JA, et al. Risk stratification for arrhythmic events in patients with asymptomatic pre-excitation: A systematic review for the 2015 ACC/AHA/HRs guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016 Apr 5;133(14):e575–86.
Mohammad A, Saeed M, Babylon FM-MJ of, 2019 U. Effectiveness of the modified valsalva maneuver in the emergency management of supraventricular tachycardia. Med J Babylon [Internet]. 2019 [cited 2023 Dec 10]; Available from: https://www.iasj.net/iasj/download/05b35d0731972b26
Abdulhamid AS, Almehmadi F, Ghaddaf AA, Alomari MS, Zagzoog A, Al-Qubbany A. Modified valsalva versus standard valsalva for cardioversion of supraventricular tachycardia: systematic review and meta-analysis. Int J Arrhythmia 2021 221 [Internet]. 2021 Feb 12 [cited 2023 Dec 10];22(1):1–8. Available from: https://arrhythmia.biomedcentral.com/articles/10.1186/s42444-021-00030-2
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ngurah Agung Reza Satria Nugraha Putra, I Nyoman Kurniawan Agratama, Ni Luh Eka Sriayu Wulandari, I Ketut Susila
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
