Acceleration of ventricular tachycardia induced by a chest thump

Chest thump is accepted as a simple and effective maneuver for terminating a paroxysm of ventricular tachycardia. This report describes three patients receiving digitalis in whom chest thump caused an acceleration of the rate of ventricular tachycardia. Following discontinuation of digitalis therapy, chest thump converted to sinus rhythm recurrence of ventricular tachycardia in two patients and did not cause acceleration of the ventricular rate in the third. It is suggested that in patients taking digitalis with ventricular tachycardia, chest thump should be used with caution.