The Efficacy of Carotid Massage Versus Ice Bag Maneuver by Trained Nurses for Children With Paroxysmal Supraventricular Tachycardia: A Randomized Controlled Trial.
Doaa El Amrousy, Amany Shwitah, Rahma Soliman Bahgat et al.
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In 30 seconds
This randomized controlled trial compared nurse-administered carotid sinus massage with an ice bag maneuver for terminating paroxysmal supraventricular tachycardia in 120 hemodynamically stable children presenting to a pediatric emergency department. Success was return to sinus rhythm within 5 minutes. This occurred in 26 children (43.3%) receiving carotid massage and 14 (23.3%) receiving the ice bag maneuver. The carotid massage group also had lower antiarrhythmic drug use and shorter hospital stays; minor side effects did not differ significantly between groups.
Key findings
- Sinus rhythm returned within 5 minutes in 26 children (43.3%) after carotid massage versus 14 (23.3%) after the ice bag maneuver.
- Antiarrhythmic drug use and hospital stay duration were significantly lower in the carotid massage group.
- Side effects were minor, with no significant difference between the two groups.
Why it matters
The trial provides comparative evidence for two vagal maneuvers that trained nurses can administer to hemodynamically stable children with paroxysmal supraventricular tachycardia. The higher short-term termination rate and lower reported need for antiarrhythmic drugs with carotid massage may inform emergency department assessment of these approaches, while the findings apply to the studied pediatric population and setting.
What to keep in mind
The abstract reports outcomes only within 5 minutes for rhythm conversion and does not provide longer-term follow-up or detailed safety outcomes.