Balloon Blowing Facilitates the Termination of Paroxysmal Supraventricular Tachycardia: Comparing the Practicality and Efficacy of Balloon With Syringe-Based Valsalva Maneuver

OBJECTIVE: The purpose of this study was to assess the practicality and efficacy of balloon insufflation versus syringe-based modified Valsava maneuver (VM) for terminating paroxysmal supraventricular tachycardia (PSVT). METHODS: Pressure generation tests compared latex balloons (uninflated diameters: 5.7-6 cm) and 10-ml syringes. A total of 103 hemodynamically stable PSVT patients presenting in the emergency department (ED) were random assigned to perform the modified VM using either a balloon ( n = 58) or a syringe ( n = 45). Primary outcome was a cardioversion of sinus rhythm. RESULTS: We found that when blowing air into a balloon, we were able to reach the target intrathoracic pressure (40-60 mmHg; mean 47.8 mmHg for 5.8-cm balloon) required for VM. A total of 103 patients were randomized to perform the modified VM. Among them, cardioversion success was 50% (29/58) in the balloon group versus 55.6% (25/45) in the syringe group ( p = .575). Balloon insufflation was visibly effective in 100% of patients versus 36.4% with syringes ( p < .001). CONCLUSION: In this study, the patients in the ED showed that the modified VM using a balloon was effective in terminating PSVT with which the balloon allowed for visible insufflation. Its simplicity and visibility make it preferable in emergency and community settings, reducing reliance on invasive interventions.