“…All studies 3,4,[6][7][8][11][12][13][14][15][16][17][18][19][20][21][22][23][24] reported the overall rate of cardioversion, including that associated with single and multiple Valsalva maneuvers, and 12 studies 3,4,7,[11][12][13][15][16][17][18][19]24 reported the rate of cardioversion after a single Valsalva maneuver. Eight studies 4,7,11,13,15,20,22,24 repeated the standard or modified Valsalva maneuver up to two times if sinus rhythm was not restored after the first attempt, three studies 6,16,21 repeated the maneuver up to three times, two studies 17,18 repeated the maneuver up to five times, and six studies 3,8,12,14,…”