What Are Vagal Maneuvers for a Fast Heart Rate?

It can be scary when your heart suddenly starts to race. If you have a heart rate of more than 100 beats per minute doctors, call it tachycardia.

With tachycardia or another type of heart rhythm problem, such as arrhythmia, there may be simple steps you can take to slow your heart down right away. They're called "vagal maneuvers." They affect the vagus nerve, a long nerve that runs from your brain to your belly and helps control your heart rate.

Vagal maneuvers may seem easy, but they’re not without risks and aren't right for everyone. You should only do them if your doctor has explained when and how.


The following maneuvers may help you slow your heart rate or even settle your heart into its normal rhythm:

  1. Holding your breath and bearing down as if having a bowel movement. This creates pressure in your chest that may activate the vagus nerve. Sitting or squatting may help. Try it for 10 seconds.
  2. Coughing. You need to cough hard to generate pressure in your chest and stimulate the vagus nerve. Children with tachycardia may not be able to cough hard enough to get a response from the vagus nerve.
  3. Holding your knees against your chest for a minute. This may be more effective for babies and children.
  4. Cold water treatment. You may need to put a plastic bag of ice over your face for 15 seconds. Or you can immerse your face in icy cold water for several seconds. It might also work to step into a cold shower or a cold bath.

Other vagal maneuvers include massaging the sides of your neck where the carotid arteries are located or pressing gently on your eyes when they're closed. These steps are riskier than other maneuvers, especially for older adults and children. So you shouldn't do any of these moves unless your doctor has told you to.

An older adult may be at risk during carotid artery massage because he or she may have cholesterol plaque built up in the carotid artery. Massaging the artery could cause the plaque to break up, triggering a blood clot that can cause a stroke.


Use Caution

Vagal maneuvers aren't safe for everyone with an arrhythmia. Bearing down, also called the Valsalva maneuver, can put an unhealthy strain on your heart. It can also raise your blood pressure. If you have coronary heart disease, a congenital heart defect, or other cardiac conditions, your doctor may advise you not to do the Valsalva maneuver.

If you sometimes have episodes of tachycardia, talk with your doctor about all your treatment options. Don't try a maneuver until your doctor has carefully demonstrated how to do it safely. And if you ever have questions, call your doctor's office.

When to Call 911

When your doctor teaches you how to do a vagal maneuver, ask how long you should do it before stopping. You should also know when to stop and call 911. For many people who have tachycardia, waiting 30 minutes may be sufficient.

Often, a rapid heart rate will ease on its own. But if your doctor recommends you learn one or more vagal maneuvers to slow your heart down, you may be able to cut short the unsettling feeling that comes with a racing heart.

WebMD Medical Reference Reviewed by Suzanne R. Steinbaum, MD on March 27, 2017



American Heart Association: "Tachycardia/Fast Heart Rate."

Mayo Clinic: "Tachycardia: Symptoms and Causes."

Society for Cardiovascular Angiography and Interventions: "Ice Bucket Challenge -- For the Heart?"

Cleveland Clinic Wellness: "What Happens in Vagus."

UCSF Department of Surgery: "Arrhythmias."

Stanford Health Care: "Vagal Maneuver Treatment."

American Heart Association: "Congenital Heart Defects and Physical Activity."

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