What is the "bearing down" method?

I've noticed some of you talking about using the "bearing down" method to help slow a fast heart rate. I'm curious - what is that exactly? I have an ICD because I survived an SCA. Nowadays, if I feel my heart racing, I do a few deep breaths (in for 4, out for 6) and it seems to settle things down. I'm always open to other methods though!! In addition to the "bearing down" method, are there other things you guys do to slow your heart rate? I like to avoid getting shocked when I can!

4 Comments

Bearing down

by AgentX86 - 2022-09-19 22:53:56

This is one of the "Vagal maneuvers".  This particular one can be compared to going to the bathroom, without going to the bathroom.  There are others that you can try.  They work for some and sometimes for others, and not for others. They're certainly worth a try.

https://www.webmd.com/heart-disease/atrial-fibrillation/vagal-maneuvers-and-heart-rate

Modified Valsalva manoeuvre

by Gemita - 2022-09-20 01:50:20

Hello Lildanishgirl, it is good to hear from you again.  To add to AgentX86 comment, there is a newer technique called the Modified Valsalva manoeuvre.  I attach a link which gives good info.  

See also short video (second link) and the full Lancet article for indications when to use this method.  There are some contraindications and in any event with your ICD I would always ask your doctors whether this technique would be suitable for you to try to help stop an arrhythmia before you get an ICD shock.

The trials for the modified Valsalva manoeuvre seem to cover Supraventricular tachy arrhythmias that originate from atrial or AV nodal tissue including atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial tachycardia, which is more common in patients with Wolff-Parkinson-White syndrome.  It would appear that Atrial Fibrillation and Flutter were not included in the trials, nor sinus tachycardia, so I am unclear how effective this modified technique is likely to be with all atrial arrhythmias. 

I suffer from a variety of atrial tachy arrhythmias and will try anything in an attempt to stop them, so why not have a try, with your doctor’s blessing of course?  Positional changes or activities that can increase my abdominal/chest pressure like coughing, trying to blow through closed lips while pinching nose, can work well for me.  I also take sips of hot or ice cold water during a fast arrhythmia because one or both can help with my occasional swallowing induced tachycardia.

https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/HANDI/Modified-Valsalva-manoeuvre-for-supraventricular-tachycardia.pdf

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61485-4/fulltext#sec1

I would discuss with the Cardiologist

by Rch - 2022-09-20 17:21:24

Hi, reading your history of valvular heart dz, arrhythmias, cardiac arrest, ICD etc , I would consult the Cardiologist on your new symptoms. He/She might consider titrating up the beta blockers. You could still try the modified valsalva if it helps. I would also consult the Gyn or Pediatrician if higher beta blockers would adversely affect your newborn if you're still nursing.

EP’s Instruction

by DoggieMama - 2022-09-22 01:44:33

I just got a BiV ICD on Sept 6 (along with some complications). Before I left the hospital, my EP told me to NOT bear down when having a bowel movement. 
 

That being said, I think you should talk to your docs before trying something similar. 

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