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September 9, 1974

Version of Arrhythmia

Author Affiliations

University of Virginia Medical Center Charlottesville

JAMA. 1974;229(11):1420. doi:10.1001/jama.1974.03230490022007

To the Editor.—  Four years ago, termination of ventricular tachycardia by a simple, brisk blow of the fist over the heart became hospital coronary care unit practice.1 We have seen four such patients survive prehospital and hospital care and return to active life. Recently, thumpversion was justifiably incorporated into the revised standards for cardiopulmonary resuscitation and emergency cardiac care (227:833, 1974). Resultant electromechanical transduction provides energy adequate to depolarize a reentry pathway and thereby abolish ventricular dysrhythmias.We recently observed an 81-year-old man, with a history of myocardial infarction ten years earlier, who had sudden palpitation and became weak and dizzy. When seen by the mobile coronary care unit team, he had new, low-frequency, high-amplitude atrial fibrillation and frequent ventricular ectopic beats. He was placed on a stretcher, monitored continuously, and treated with oxygen. A mile from the hospital, the ambulance drove over a partially filled trench in the