Has your heart rate suddenly increased? Let's talk about these Vagal Maneuvers!

When you're feeling down, has your heart suddenly started beating faster... much faster for no reason? It feels like you've just run away, or you're really scared, right? It's normal to feel a little scared at times like this. Most of the time, this is caused by a sudden increase in heart rate. Today, we're going to talk about some simple, non-drug methods that doctors use to treat this.

What exactly are Vagal Maneuvers?

Simply put, Vagal Maneuvers are certain activities that we do with our bodies. These stimulate a nerve that controls our heart rate. We call this nerve the Vagus nerve . This is a very important nerve that runs from our brain to our stomach.

Think about it, our body has two systems. One is to make us active, to prepare us for an emergency. The other is to calm us down, to keep us relaxed. This second system is called the Parasympathetic Nervous System . The main part of that system is the Vagus nerve. So when we stimulate this nerve a little, it sends a signal to the heart saying, "Okay, slow down a little now." Then the natural pacemaker of the heart slows down, and the fast heartbeat can return to normal.

What are these types of Vagal Maneuvers?

There are several methods that doctors commonly use. You may have heard of one or two of these.

Why use these methods?

The main cause is a condition called Supraventricular Tachycardia (SVT) . This is when electrical signals originating in the upper parts of the heart cause the heart rate to suddenly increase to much higher than 100 beats per minute. For someone with this condition, doctors first try Vagal Maneuvers.

Because,

• Low risk: These are much safer than giving medication or giving an electric shock (cardioversion).
• Low cost: This does not require special equipment or medication.
• Can be done quickly: Can be done quickly at the hospital or clinic.

These methods have a 20% to 40% success rate in restoring a normal heart rate. Sometimes, these methods can also help doctors determine exactly what type of heart rhythm disorder (arrhythmia) you have.

Are there people who should not do these procedures?

Yes, absolutely. A doctor will only use these methods if your condition is stable . That is, if you are not in serious trouble. But if your condition is unstable , that is, if you have the symptoms below, these methods will not be used. At that time, they will directly refer to other treatments.

Let's briefly explain how the main methods are performed.

1. Valsalva Maneuver

This is the most commonly used method. The way a doctor does this is by having you lie down on a bed, take a deep breath, close your mouth and nose, and hold it for about 10-30 seconds as if you were trying to blow out the breath. It should feel like you are trying to blow into a blocked pipe.

There is another successful method of this. It is called the Modified Valsalva Maneuver . In it, as you sit and do this push, the doctor suddenly lowers your upper body on the bed. At the same time, he raises both legs and holds them for about 45 seconds. This increases the success rate even more.

To do this to small children, doctors tell them to put their thumb in their mouth and blow until no air comes out.

2. Diving Reflex

This may sound a little strange, right? But it's also a very effective method. What you do here is, you sit down, take a deep breath, hold your breath, and suddenly immerse your entire face in a basin filled with ice water. You want to keep your face in the water for as long as possible.

As an alternative to this, you can hold a bag of ice water or a very cold wet towel against your face.

3. Carotid Sinus Massage

This is something that should only be done by a doctor. You are absolutely not allowed to do it yourself. Because you need to know exactly where to do it and apply the right amount of pressure.

Here, the doctor will have you lie down, turn your head to one side, and gently massage the carotid sinus on the side of your neck with his fingers for about 5-10 seconds. This can slow down your heart rate.

What happens after these methods?

The hope is that the heart rate will return to normal. The doctor will perform another EKG (electrocardiogram) to see if the heart rhythm has returned to normal.

If these methods don't work after two or three attempts, you may be given medication. This means intravenous medication can be given to control your heart rate. In some cases, you may be referred for cardioversion, which involves giving an electric shock.

Whether successful or not, if this situation arises, your doctor may refer you to a cardiologist.

What are the risks and benefits of this?

We've already talked about the advantages. The main advantage is that you can try to control your heart rate without medication, at low cost, and with low risk.

As for risks, when performed correctly by a qualified doctor, complications are very rare. Even if they do occur, they are usually temporary.

• Hypotension: A temporary drop in blood pressure.
• Bradycardia: Excessively slow heart rate.
• Very rarely, other heart rhythm problems such as Atrial Fibrillation and Ventricular Fibrillation may occur.

The risk of stroke with Carotid Sinus Massage is very low, about 1 in 1,000. For this reason, doctors do not use this method for people with the following conditions:

• If you have had a previous stroke or TIA (transient ischemic attack) .
• If you have carotid artery disease .
• If you have recently had a heart attack.