Waxman M B, Wald R W, Finley J P, Bonet J F, Downar E, Sharma A D
Circulation. 1980 Oct;62(4):843-51. doi: 10.1161/01.cir.62.4.843.
Nine patients with recurrent ventricular tachycardia (VT) that could be repeatedly terminated by a Valsalva maneuver are described. In two, the tachycardia would cease for only a few seconds and then resume, whereas in seven, the tachycardia could be permanently and reproducibly terminated with a Valsalva maneuver. In all patients the tachycardia ended during the strain phase of the Valsalva maneuver, when blood pressure and radiographic measurement indicated that cardiac dimensions had been reduced dramatically. The speed with which the Valsalva maneuver terminated VT incresed in direct proportion to the strain pressure. Maneuvers such as standing or nitroglycerin, which independently reduce cardiac dimensions, enhanced the potency of the Valsalva maneuvers. Pretreatment with atropine or propranolol in four patients did not alter the response of VT to the Valsalva maneuver. Thus, it appears that a strong Valsalva maneuver can terminate some forms of VT, most likely related to an abrupt reduction in cardiac dimensions.
本文描述了9例复发性室性心动过速（VT）患者，其室性心动过速可通过瓦尔萨尔瓦动作反复终止。其中2例，心动过速仅停止数秒后就会恢复，而在7例中，瓦尔萨尔瓦动作可永久性且可重复地终止心动过速。在所有患者中，心动过速均在瓦尔萨尔瓦动作的用力阶段结束，此时血压和影像学测量表明心脏尺寸已显著减小。瓦尔萨尔瓦动作终止室性心动过速的速度与用力压力成正比。诸如站立或使用硝酸甘油等能独立减小心脏尺寸的动作，增强了瓦尔萨尔瓦动作的效力。4例患者使用阿托品或普萘洛尔预处理并未改变室性心动过速对瓦尔萨尔瓦动作的反应。因此，似乎强烈的瓦尔萨尔瓦动作可终止某些形式的室性心动过速，这很可能与心脏尺寸的突然减小有关。
