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NASVAL-SVT: Nasal Swab Versus Modified Valsalva for Supraventricular Tachycardia

RecruitingNAAges 18 Years - anyAllMarmara University Pendik Training and Research H…
NCT07617077 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Supraventricular tachycardia (SVT) is a common heart rhythm disorder seen in emergency departments, causing a rapid heartbeat (typically 150-250 beats per minute). The current best non-drug treatment, the modified Valsalva maneuver (mVM), successfully restores normal rhythm in about 43% of cases. When these maneuvers fail, intravenous adenosine is used, which, while effective, can cause brief but distressing side effects such as chest tightness, shortness of breath, and intense anxiety. During the COVID-19 pandemic, some patients briefly fainted during nasal swab collection. This happens because inserting a swab into the back of the nasal cavity (nasopharynx) stimulates the trigeminal nerve, which then activates the vagus nerve and slows the heart - a phenomenon called the trigeminocardiac (or nasocardiac) reflex. One published case report described a patient whose SVT was terminated wi

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age 18 years or older * Electrocardiographically confirmed supraventricular tachycardia (SVT): narrow QRS complex (≤120 ms), regular rhythm, rapid ventricular rate, documented on 12-lead ECG or continuous cardiac monitoring * Hemodynamic stability, defined as ALL of the following simultaneously present: * Systolic blood pressure ≥90 mmHg * Diastolic blood pressure ≥60 mmHg * Alert and oriented mental status (GCS 15) * No signs of acute end-organ dysfunction * Ability and willingness to provide written informed consent Exclusion Criteria: * Age younger than 18 years * Pregnancy (known or suspected) * Inability to confirm SVT diagnosis by ECG criteria * Delta wave or pre-excitation pattern on ECG (Wolff-Parkinson-White syndrome or asymptomatic pre-excitation) - due to risk of ventricular fibrillation with vagal maneuvers * Wide QRS tachycardia (QRS ≥120 ms) where ventricular tachycardia cannot be excluded * Absolute contraindication to modified Valsalva maneuver (inability to assume supine position or passive leg elevation) * Contraindication to nasal swab (nasal surgery within 30 days, active epistaxis, visible nasal polyp or mass) * Hemodynamic instability requiring immediate synchronized cardioversion * Prior enrollment in this study (re-presentation with SVT) * Refusal to participate
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What it tests

  • Nasopharyngeal Swab Insertion
  • Modified Valsalva Maneuver (REVERT Protocol)
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Where

1 site
Marmara University Pendik Training and Research Hospital
Istanbul, Turkey (Türkiye)
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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