Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
To the Editor: Dr Maron and colleagues1 reported that ventricular tachycardia/fibrillation
was identified in 36 of 82 cases of commotio cordis and that most were successfully
resuscitated by an external defibrillator.
Time is of the essence in treating this lethal tachyarrhythmia, and
external defibrillators are often unavailable. Thumpversion,2
or a manual thump to the precordium, has been shown to be effective in terminating
both ventricular tachycardia and ventricular fibrillation.3
It might seem to be a paradox to treat commotio cordis, which is caused by
a chest blow, by a second precordial thump. Caldwell et al,4
however, reported that thumpversion was efficacious in a prospective study
of 5000 medical-surgical patients. Therefore, a chest blow is apparently a
double-edged sword: it can cause sudden ventricular arrhythmias but also terminate
Cheng TO. Emergency Treatment for Commotio Cordis. JAMA. 2002;287(23):3080. doi:10.1001/jama.287.23.3077
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: