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Terminating ventricular fibrillation by chest thump
Insights
A chest thump successfully converted ventricular fibrillation to sinus rhythm in a patient with a history of atrial septal defect. This is the first reported case of mechanical conversion for ventricular fibrillation.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Medical Case Reports
Background:
- A 41-year-old male with a surgically repaired atrial septal defect experienced prolonged anginal symptoms.
- The patient underwent coronary angiography for diagnostic evaluation.
Observation:
- During coronary angiography, the patient developed ventricular fibrillation.
- A precordial thump was administered, successfully converting the ventricular fibrillation to sinus rhythm.
Findings:
- This case represents the first documented instance of successful mechanical conversion of ventricular fibrillation using a chest thump.
- The mechanism may involve interruption of re-entrant pathways or suppression of ectopic impulses by the mechanical stimulus.
Implications:
- Chest thump may be a viable, immediate intervention for certain life-threatening arrhythmias.
- Further research is warranted to elucidate the precise mechanisms and clinical utility of mechanical cardioversion.
Abstract:
A 41-year-old man with a surgically closed atrial septal defect presented with anginalike symptoms of 5 years duration. While undergoing coronary arteriorgraphy, the patient sustained ventricular fibrillation which was converted successfully to sinus rhythm by a chest thump. This is the first reported case of such conversion. The mechanism of mechanical conversion from ventricular tachycardia, or fibrillation, to sinus rhythm may be that the mechanical stimulus interrupts a re-entry pathway or depresses ectopic impulses to allow the normal sinoatrial rhythm to emerge.