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Conversion of SVT tends to be easier if the patients are reclining. On the paramedic courses we teach this!! So Valsalva and other manoeuvres work better with subjects lying. Part of mechanism thought to be baroreceptor reflexes and these are more active when legs are raised... This is well known. One recent paper:- Ann Emerg Med. 2004 Apr;43(4):477-82. Vagal response varies with Valsalva manoeuvre technique: a repeated-measures clinical trial in healthy subjects. Wong LF, Taylor DM, Bailey M. But described much before this!! Regards Dave Fletcher ----- Original Message ----- From: Taffler Richard (RJ9) West Country Ambulance Services TR To: [log in to unmask] Sent: Wednesday, September 21, 2005 10:18 AM Subject: [ACAD-AE-MED] SVT and raised legs! Several paramedics have recently reported the conversion of SVT to NSR by raising the patients legs. Previous attempts (carotid massage/valsalva) had proved ineffective for these patients, who were normotensive, although displaying signs of circulatory compromise (pale, sweating, dizzy etc). Does any member of the list have any evidence (anecdotal or otherwise) that may explain this phenomenon please? Richard Taffler BSc(Hons) BEng GASI SRPara Clinical Effectiveness Officer Westcountry Ambulance NHS Trust *********************************************************************************** This email and any attachments are confidential and may be privileged or otherwise protected from disclosure. If you are not the intended recipient you must not copy this message or any attachment or disclose the contents to any other person. If you have received this message in error please contact us by email at [log in to unmask] This footnote also confirms that this email message has been swept for the presence of computer viruses. You should carry out your own virus checks before opening any attachment. The Westcountry Ambulance Service accepts no liability for any loss or damage which may be caused by software viruses. ***********************************************************************************