- Daniel R Frisch, MD
Daniel R Frisch, MD
- Assistant Professor of Medicine
- Thomas Jefferson University
- Peter J Zimetbaum, MD
Peter J Zimetbaum, MD
- Section Editor — Cardiac Arrhythmias
- Associate Professor of Medicine
- Harvard Medical School
The autonomic nervous system is composed of the sympathetic and parasympathetic divisions. This system innervates and regulates most visceral functions including electrophysiological and hemodynamic cardiovascular responses.
Various physical maneuvers can elicit autonomic responses. Many of these maneuvers can be performed at the bedside or in an office setting with minimal risk. These maneuvers can be both diagnostic (eg, in confirming carotid sinus hypersensitivity) and therapeutic (eg, terminating paroxysmal supraventricular tachycardia). Understanding the indications, techniques, and complications of various vagal maneuvers is necessary to safe and effective clinical application.
A wide variety of physical maneuvers can have intended or unintended influence on increasing vagal tone. These include:
●Carotid sinus massage (see 'Carotid sinus massage' below)
●Valsalva maneuver (standard or modified technique) (see 'Valsalva maneuver' below)
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- CARDIAC RESPONSES TO VAGAL STIMULATION
- CLINICAL USES
- CHOICE OF MANEUVER
- VALSALVA MANEUVER
- Valsalva maneuver technique
- Valsalva maneuver monitoring
- Blood pressure responses following a Valsalva maneuver
- Heart rate responses for patients with SVT
- CAROTID SINUS MASSAGE
- Carotid sinus massage technique
- Carotid sinus massage monitoring
- Responses to carotid sinus massage
- DIVING REFLEX
- OCULOCARDIAC REFLEX
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS