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January 1982

Treating Paroxysmal Supraventricular Tachycardia

Author Affiliations

Ames, Iowa

Arch Intern Med. 1982;142(1):201. doi:10.1001/archinte.1982.00340140203044

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To the Editor.  —I read with interest the article by Mathew entitled "Diving Reflex: Another Method of Treating Paroxysmal Supraventricular Tachycardia" in the January Archives (1981;141:22-23).

Report of a Case.  —While an internal medicine resident in training, I treated a 54-year-old man who was initially seen at an emergency room with a paroxysmal supraventricular tachycardia, mild dizziness, and shortness of breath. His ECG tracing disclosed a narrow, complex regular tachycardia with a heart rate of 180 beats per minute. An intravenous line was secured, and I instructed the emergency room nurse to prepare a basin of ice water for facial immersion. The patient was seated on the emergency room cart with his back elevated to 80°. As the nurse positioned the ice water on the table in front of him, the basin was jarred, and a large quantity of ice water splashed directly on his scrotum. His cardiac rhythm converted

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