The ALS Ice Bucket Challenge has gone viral and taken fundraising to new heights. Perhaps you, your family or your friends have filmed your own videos to support the cause. But are you aware that there is an ice bucket challenge that can treat a heart condition? Yes, a heart condition! Read on to learn how the ice bucket can be used to treat a specific heart condition.

Cooling Off a Racing Heart

Tachycardia is a condition where the heart is beating too fast because the electrical impulses that normally control how the heart beats have been disrupted. There are different types of tachycardia, including supraventricular tachycardia (SVT), whichoccurs when the heart is beating too rapidly because of an abnormal rhythm that started in the upper chambers of the heart.

If you experience SVT, it may feel like your heart is racing – beating too hard and fast for what you are doing. You might experience chest pain or dizziness or you might faint. SVT can come on suddenly, without warning, and it can be frightening.

While SVT and other episodes of tachycardia usually stop on their own, there are techniques that have been shown to slow down a racing heartbeat. Using these techniques – called vagal maneuvers – does not require a medical degree, but you should not try them without first discussing them in detail with your doctor (or your child’s doctor). Your doctor can help you understand when to use a vagal maneuver and how to do it safely.

What Is a Vagal Maneuver?

A vagal maneuver is a specific, simple action that stimulates the vagal nerve (also known as Cranial Nerve X), which can slow down the electrical impulses that are causing the heart to beat too fast. One type of vagal maneuver involves sudden exposure to cold – such as ice water in the face. This type of vagal maneuver is sometimes called a “diving reflex” because whales, seals, dolphins and penguins use it to help them stay underwater for long periods of time.

In addition to cold water in the face, other types of vagal maneuvers include holding your breath while bearing down (also known as the Valsalva maneuver), knee-to-chest compressions, hard coughing and carotid sinus massage. Let’s look at each one.

The Diving Reflex

The diving reflex is how the body typically responds if the face is suddenly exposed to icy water. To slow down the racing heartbeat that occurs with SVT, the patient lies down and a zipper-lock bag filled with ice and water is quickly placed over the face, including the nose and mouth to prevent breathing. The bag is kept in place for about 15 seconds and then removed. This can be tried several times, each time checking the pulse to see if the heart rhythm has slowed to normal. If this does not work after three or four attempts, it is time to seek medical help.

The Valsalva Maneuver

The Valsalva maneuver can stop an episode of SVT by increasing the pressure in the chest and activating the vagus nerve. Performing the Valsalva maneuver involves holding your breath and then sharply bearing down, as if you are trying to poop, for about 10 seconds. Sometimes sitting or squatting can help.

Knee-to-Chest Compression - for Babies and Young Children

For babies or young children with SVT, pressing the knees to the chest and holding them there for about a minute can cause a response similar to the Valsalva maneuver. While this can be successful for some babies and toddlers, an ice-water bag to the face may be more effective.

Hard Coughing

Hard coughing works like the Valsalva maneuver, with the force of hard coughing creating pressure in the chest and stimulating the vagus nerve. While coughing may work for adults, children may not be able to cough hard enough to cause a good response.

Carotid Sinus Massage

The area near the jawline (called the carotid sinus) has receptors that help maintain normal blood pressure. During an episode of SVT, vigorously massaging this area may cause a vagal response that slows down an abnormally fast heartbeat. In some people, however, this maneuver can cause the blood pressure to drop suddenly, resulting in dizziness and fainting. This maneuver should not be tried in older people who may have blockages in the neck arteries that carry blood to the brain (the carotid arteries).  Massaging these areas could dislodge plaque that has built up inside the artery and cause a stroke. Carotid sinus massage should never be undertaken without a doctor’s approval. 

Remember - Vagal Maneuvers Require Talking with a Doctor 

The Ice Bucket Challenge is raising money and awareness for a good cause. It’s also yielding some funny videos and hilarious facial responses. And it can also “shock” your heart back to a normal rhythm!

But, if you or someone you love experiences SVT, ice-water treatments and the other vagal maneuvers reviewed here should be tried only if you have discussed them in detail with your doctor.

Questions to Ask Your Doctor About Vagal Maneuvers

Considering my (or my child’s) heart condition, how likely is supraventricular tachycardia (SVT)?

If I (or my child) experiences SVT, should we try a vagal maneuver? Which one?

Can you teach me how to do the vagal maneuver?

What Should I Do If I Have Other Questions?

Ask them. Contact your healthcare provider and ask all of your questions. Any time you have health questions, the conversations you have with your doctor are the key to successful results. Ask every question you have.

We hope you will use SecondsCount.org to learn more about your cardiovascular health and treatment options. SecondsCount.org was developed by the Society for Cardiovascular Angiography and Interventions (SCAI), the medical society for interventional cardiologists.