Nasal Swab vs Modified Valsalva for SVT

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized, two-phase, single-center study compares a nasopharyngeal swab technique to the REVERT-modified Valsalva maneuver for terminating supraventricular tachycardia in adults who are hemodynamically stable. Participants with ECG-confirmed SVT and stable vital signs are randomized to receive either a nasal swab insertion or the REVERT protocol in the emergency setting. The aim is to determine whether nasal stimulation can rapidly terminate SVT using the trigeminocardiac reflex, potentially reducing need for medication or longer procedures. Safety monitoring includes tracking bradycardia, hypotension, or other adverse events during the intervention. The trial builds on observations of reflex-mediated heart rate changes during upper airway stimulation and seeks to quantify effectiveness and safety in a controlled clinical context.

Why it matters

Who can join: the full rules

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

Where it's running

• Marmara University Pendik Training and Research Hospital
  Istanbul, Pendik, Turkey (Türkiye) Recruiting

Study contacts

• Study coordinator: Emir Ünal
• Email: emirunal@gmail.com
• Phone: +905327766010

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.