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

Hari N. Krishnakumar, Shwetha R. Menon, Alireza Mirahmadizadeh, Ali Seifi

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)1027-1034
Number of pages8
JournalExpert Review of Medical Devices
Issue number12
StatePublished - 2023
Externally publishedYes


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

ASJC Scopus subject areas

  • Surgery
  • Biomedical Engineering


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