{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:57:30Z","timestamp":1787500650361,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,6,14]]},"abstract":"<jats:p>Patients with attacks of re-entrant supraventricular tachycardia (SVT) frequently present to the emergency department (ED). The Valsalva manoeuvre (VM) is the most effective and safe vagal manoeuvre and advocated as the first-line treatment in stable patients but has a relatively low cardioversion success rate. Improving its efficacy would reduce patients\u2019 exposure to the side effects and complications of second-line treatments and has other potential benefits. We describe a modification to the VM, which is currently being studied, and present the case of a 23-year-old patient who was successfully treated with this modified VM after a previous near-fatal complication of direct current (DC) cardioversion.<\/jats:p>","DOI":"10.1136\/bcr-2013-202699","type":"journal-article","created":{"date-parts":[[2014,7,8]],"date-time":"2014-07-08T11:00:47Z","timestamp":1404817247000},"page":"bcr2013202699","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Modified Valsalva manoeuvre to treat recurrent supraventricular tachycardia: description of the technique and its successful use in a patient with a previous near fatal complication of DC cardioversion"],"prefix":"10.1136","volume":"2014","author":[{"given":"Andrew","family":"Appelboam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Gagg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Reuben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,7,8]]},"reference":[{"key":"2025042706035874000_2014.jul08_1.bcr2013202699.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2009.01228.x"},{"key":"2025042706035874000_2014.jul08_1.bcr2013202699.2","doi-asserted-by":"crossref","unstructured":"Smith GD Dyson K Taylor D . 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