Forced inspiratory suction and swallow tool (FISST): an automation of Valsalva maneuver variants for therapeutic interventions

ABSTRACT

Introduction

The Valsalva maneuver and its modifications have been utilized across several conditions in medicine; however, there have been difficulties in its application. Thus, at the University of Texas Health Science Center in San Antonio, we designed and patented an affordable and accessible device that mimics Valsalva called “Forced Inspiratory Suction and Swallow Tool (FISST).

Areas Covered

In this review, we discuss the premise for the design of FISST, based on applications of the law of conservation energy, the continuity equation, and Bernoulli’s principle. We then detail the mechanism by which FISST stimulates hiccup cessation by increasing negative inspiratory pressure when drinking through the apparatus, causing diaphragmatic contraction and disruption of the hiccup reflex. We then detail the efficacy and future applications of FISST in addressing other pathologies.

Expert Opinion

FISST has been used to address hiccups by utilizing its reverse-Valsalva effect to increase parasympathetic stimulation by increasing vagal tone. In a prospective study that we conducted on a cohort of 249 hiccup subjects worldwide, this tool achieved 92% effectiveness. Additionally, several cases, including a published case report, have found FISST successful in terminating supraventricular tachycardias (SVT). FISST may be further utilized in diagnosing or addressing various upper airway pathologies and should be explored further.

KEYWORDS:

• Hiccups
• Bernoulli’s principle
• forced inspiratory suction and swallow tool
• home remedies
• HiccAway
• Valsalva
• Supraventricular Tachycardia

Article highlights

• At the University of Texas Health Science Center at San Antonio, we designed and patented an affordable and easily accessible device with the scientific name ‘Forced Inspiratory Suction and Swallow Tool (FISST)’ and branded it as ‘HiccAway’.’

• The premise for the functionality and design of FISST is based on applications of the law of conservation energy, the continuity equation, and Bernoulli’s principle.

• FISST has been used to address both hiccups and supraventricular tachycardias (SVT) by utilizing its reverse-Valsalva effect to increase vagal tone and parasympathetic stimulation.

• We tested the effectiveness of FISST as a prospective study on a cohort of 249 hiccup subjects worldwide. The results were published in JAMA with 92% effectiveness compared to the home remedies.

• We call for future studies to test the utility of this device in the diagnosis and treatment of other conditions, considering that FISST is now available to the public as an over-the-counter tool, HiccAway

Declaration of interest

A Seifi, is the inventor and patent holder for the study device (FISST), branded as HiccAway. He has pitched this device on the Shark Tank show by abc TV and has been receiving the fund from Mark Cuban and loyalty from the University of Texas Health at San Antonio for his invention. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors have contributed to the work, agree with the presented findings.

Additional information

Funding

This paper was not funded.