Ambulance service trials new device for patients with a fast heartbeat

The South Western Ambulance Service NHS Foundation Trust (SWASFT) is trialing a new device for patients with an abnormally fast heart rhythm.

The Valsalva Assist Device, known as VAD, is being used to help return a patient’s heartbeat back to a normal rate, which could help reduce hospital admissions across the region, if there are no other clinical concerns.

SWASFT is the only service in the country to trial this new device for patients who have supraventricular tachycardia (SVT). SVT occurs when there’s a problem with the heart’s electrical system which controls the rhythm. Symptoms include heart palpitations, chest tightness, dizziness, light-headedness, or breathlessness.

Approximately 125,000 patients are affected by the condition in the UK every year. Data suggests that an ambulance service the size of SWASFT would see more than 400 patients a year with the condition.

The research into this new treatment, known as the EVADE study, is being led by Prof Andrew Appelboam, Consultant in Emergency Medicine at the Royal Devon University Healthcare NHS Foundation Trust, in collaboration with Exeter Clinical Trials Unit, academics at the University of Exeter and the NIHR Applied Research Collaboration South West Peninsula (PenARC).The study is funded by the NIHR Research for Patient Benefit (RfPB) programme, and is being managed by SWASFT.

Prof Appelboam highlights that this is a significant trial given the current pressures on emergency care: “Enabling patients to remain at home, if they have been successfully treated, has major benefits for the patient and emergency services alike, particularly given the recent pressures on ambulance trusts and emergency departments.”

The Valsalva Assist Device has a built-in regulator that controls the pressure when patients blow into it (known as the Valsalva maneuver) and can reset the heart rhythm back to normal.

The new device used by paramedics’ in treating SVT is being compared to the standard way of treating the condition which previously involved blowing into an empty syringe, which at times could be unreliable. The trial will analyse whether the new method is more effective in returning the patient’s heart rate back to normal and reduces the need for hospital attendance.

Ria Osborne, Research Manager at SWASFT, said: “We’re excited to be running the EVADE study in the South West. It’s an innovative design, which could be of huge benefit to patients experiencing SVT. The study has also been featured in the British Medical Journal.

“The device is easy-to-use and can even be left with the patient for them to use if their symptoms return.

“We are hoping that the study will demonstrate that there is a reduction in patients needing to go to hospital.

“We’re incredibly grateful to our front-line crews for embracing the use of this new device, in the hope of improving patient outcomes and experiences.”

Professor Obioha Chukwunyere Ukoumunne, Professor in Medical Statistics at the University of Exeter, and NIHR ARC South West Peninsula (PenARC), supervised the statistical analysis for the study. He said: “This important trial of the Valsalva Assist Device within the region’s ambulance service could have a big impact on the number of patients admitted to hospital with an abnormally fast heart rhythm. If successful, these devices could play a crucial role in easing the burden on our NHS.

“The study uses a ‘stepped wedge cluster randomised controlled trial design’ to evaluate the Valsalva Assist Device. This means the device will gradually be rolled out to all the ambulance stations in the trial, unlike in studies that use the more traditional ‘parallel group’ trial design where only half of the stations would get to use the device.”

SWASFT is looking for feedback directly from patients who have been treated using the device. Patients can contact Beccy Summers viar.l.summers@exeter.ac.uk to share their thoughts.

SWASFT has an active and successful research, audit, and improvementdepartment. The team’s research provides the evidence that can lead to changes in practice, improvements in quality and can potentially translate into better patient care and experience.