Atrial Fibrillation Induced by Valsalva Maneuver after Cardiac Surgery

According to the recent guidelines, both vagal maneuvers and intravenous adenosine are recommended as the first-line treatment for paroxysmal supraventricular tachycardia (PSVT). We report a case of atrial fibrillation (AF) induced by the Valsalva maneuver performed to terminate PSVT in a male patient after cardiac surgery. Although the efficacy of Valsalva maneuver and modified Valsalva maneuver for PSVT treatment is well known, this case suggests that these maneuvers can have a risk of inducing AF, especially after cardiac surgery. Adenosine can be an alternative strategy when the heart rate is easily controllable by epicardial pacing wires.