Use of Valsalva Maneuver??

Has anyone with afib ever gotten themselves out of the condition by using the "Valsalva Maneuver" to get back to nsr?? I have heard that this method will work on some people. Anyone with experience?

Doug - I was instructed to try this early on in my afib career. It never worked. When I was in the ER this past spring, they had me try it with more "gusto" than I had been doing it at home. It still didn't work.

What does work sometimes for me, though, is to place both hands flat on the abdomen above the waist line - elbows out - hands lined up on the front of the abdomen (parallel - little finger resting near index finger of other hand) and then push one hand across the skin to the side and the other hand at the same time doing the same motion to the other side.... this is difficult to explain... it rubs the fibers of the abs muscle there and changes the energy patterns.... use like a kneading stroke - push in with the heels of the hands and pull out with the fingers and alternate the hands while one is pushing the other is pulling and you cross the midline of the abdomen while doing the stroke.

It worked like a charm for me and then the magic stopped. I then had a chiropractor adjust my diaphragm which was displaced. That has held for over three months.

The vagus nerve is close to that area of the diaphragm and the stimulation seems to change the electrical pattern somehow. Chiropractors know how this works and do a great job of settling down that conflicting energy.

Jackie

Doug,

I have been successful a few times in applying the maneuver. The problem was that I stayed in NSR for less than 60 seconds. The second time I tried it it didn't work. Basically, I would have to say that it hasn't worked for me.

Jackie,

What you described sounds a lot like an old established technique used for unblocking a chakra (one of several centers of energy in the body according to Buddhism) in the mid section of the body.

You seem to have found this out by yourself!

I tried this once and it worked for me too. It helps release energy and relax the muscles. I found that it only worked when afib was just beginning, not when it was in full swing.

The Valsalva Maneuver never worked for me.

Carol

Carol - exactly!

My former massage therapist told me to interrupt the energy by massaging across the muscle fibers. The times when I was most vulnerable were early evening, after a meal, sitting down to read or watch the news on TV.... it would kick in with regularity.

My new massage therapist and chiropractor work at every visit on clearing the chakras..and making sure the diaphragm is in the correct position.

I agree - it only works at the onset. If I feel the PAC's beginning, I have to stand up immediately and do the massage technique...it stops in less than a minute, usually.

Since my afib breakthrough is all but gone, I have not had to use the technique, but I'm sure glad to know it for when I do.

I couldn't explain why it works - but it has to do with the vagus nerve.

Jackie

Interesting. I am a massage therapist and when I went in to my first AFIB a few months ago, I was in the hospital because I didn't know anything about it. There were some triggers invluding drinking the night before, drinking very cold water and jumping on the trampoline. Anyway, I was in AFIB and starting massaging my thighs because they were sore. I have no clue about this but after about a minute of this, I was in complete normal sinus rhythm. Don't know if I changed enrgy patterns or what but nothin they were doing was sorking including Cardizam and some other pushes they were giving me. Perhaps the Cardizam kicked in after all those hours. Maybe I helped with the massage. Just don't know. NO more episodes. I take magnesium, chew it up, and cut way back on my tenormin which slows my heart down. I have been on it for years. Fifty MG. per day. Got on it because my heart was skipping occassionally for many years and the doc said it would help. Have since learned that the PVC's are not uncommon. Great board thanks everyone.
JOhn Q

Doug,

I have had some success in the past using voluntary apnea (breath holding) to terminate an episode. This is akin to a Valsalva maneuver and may work through the same mechanism.

Several websites have talked about this and one reported it as being called kapalabhata, a kind of breathing in yoga.

I have found that on occasion it works for me, a vagal AFer, only for those infrequent episodes that occur in the afternoon. The vast majority of mine occur while alseep. I guess it would be kinda hard to hold my breath while I wasn't even awake. But, when realizing I'm in AF during my 2 AM bladder call, it has never worked.

My take on the mechanism is that expansion of the lungs causes pulmonary stretch fibers to fire a signal to the brainstem that then tells the vagus nerve to back off a bit, i.e., a deep breath is a vagolytic maneuver. This same reflex is responsible for respiratory sinus arrhythmia. The HR speeds up a little during inspiration and slows down a little during expiration. This is a physiologic adaptation that the body has developed over many thousands of years to become more efficient. When the lungs are expanded there is less resistance for the right ventricle to pump blood into it. Additionally there is more air in an expanded lung and gas exchange is more efficient. The reverse is true during expiration and blood flow and gas exchange are less efficient.

Accordingly, I think that vagal tone in the mid afternoon is more easily beaten back with a vagolytic maneuver v. the high vagal tone of the night. However, for me this suggests that there is something else that works in concert with diurnal vagal tone to trigger the episode at this time of day (since vagal tone is relatively low). What is it? I think dehydration is a good candidate (see previous posts on this). However, I also think that although vagal tone from the dorsal motor nucleus of the vagus nerve controls the diurnal component of its variation (measured by heart period variability - breathing is slower and shallower at night), there is another arm of the vagus nerve (goes through the nucleus ambiguus in the brainstem) that controls short term variation in vagal tone (measured by HRV or heart rate variability). This latter is more controllable by breathing.

So I think a Valsalva maneuver may diminish the total vagal tone just enough to terminate the episode. But as someone said, the episode is likely to recur unless other measures to decrease vagal tone are undertaken (I use a quick release disopyramide or Norpace). This happens a lot when I exercise. The post workout (couple hours after finishing) vagal tone can just put me over the edge into an episode. I start to feel the PACs and I just grab my diso. But voluntary apnea used to be my weapon of choice albeit less effective.

PC