Impact directly over the cardiac silhouette is necessary to produce ventricular fibrillation in an experimental model of commotio cordis Export

@article{citeulike:759470, abstract = {OBJECTIVESIn an experimental model of sudden death from chest wall impact (commotio cordis), we sought to define the chest wall areas important in the initiation of ventricular fibrillation (VF).BACKGROUNDSudden death can result from an innocent chest blow by a baseball or other projectile. Observations in humans suggest that these lethal blows occur over the precordium. However, the precise location of impact relative to the risk of sudden death is unknown.METHODSFifteen swine received 178 chest impacts with a regulation baseball delivered at 30 mph at three sites over the cardiac silhouette (i.e., directly over the center, base or apex of the left ventricle [LV]) and four noncardiac sites on the left and right chest wall. Chest blows were gated to the vulnerable portion of the cardiac cycle for the induction of VF.RESULTSOnly chest impacts directly over the heart triggered VF (12 of 78: 15\% vs. 0 of 100 for noncardiac sites: p CONCLUSIONSFor nonpenetrating, low-energy chest blows to cause sudden death, impact must occur directly over the heart. Initiation of VF may be mediated by an abrupt and substantial increase in intracardiac pressure. Prevention of sudden death from chest blows during sports requires that protective equipment be designed to cover all portions of the chest wall that overlie the heart, even during body movements and positional changes that may occur with athletic activities.}, author = {Link, Mark S. and Maron, Barry J. and Vanderbrink, Brian A. and Takeuchi, Masaaki and Pandian, Natesa G. and Wang, Paul J. and Estesiii, Mark N. A.}, citeulike-article-id = {759470}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/S0735-1097(00)01142-6}, citeulike-linkout-1 = {http://www.sciencedirect.com/science/article/B6T18-4299XNK-1J/2/0103c236f2c0b3e9a685cc2182b4cc51}, doi = {10.1016/S0735-1097(00)01142-6}, journal = {Journal of the American College of Cardiology}, keywords = {commotio-cordis}, month = {February}, number = {2}, pages = {649--654}, posted-at = {2006-07-14 22:21:47}, priority = {2}, title = {Impact directly over the cardiac silhouette is necessary to produce ventricular fibrillation in an experimental model of commotio cordis}, url = {http://dx.doi.org/10.1016/S0735-1097(00)01142-6}, volume = {37}, year = {2001} }

TY - JOUR ID - citeulike:759470 L3 - citeulike-article-id:759470 N2 - OBJECTIVESIn an experimental model of sudden death from chest wall impact (commotio cordis), we sought to define the chest wall areas important in the initiation of ventricular fibrillation (VF).BACKGROUNDSudden death can result from an innocent chest blow by a baseball or other projectile. Observations in humans suggest that these lethal blows occur over the precordium. However, the precise location of impact relative to the risk of sudden death is unknown.METHODSFifteen swine received 178 chest impacts with a regulation baseball delivered at 30 mph at three sites over the cardiac silhouette (i.e., directly over the center, base or apex of the left ventricle [LV]) and four noncardiac sites on the left and right chest wall. Chest blows were gated to the vulnerable portion of the cardiac cycle for the induction of VF.RESULTSOnly chest impacts directly over the heart triggered VF (12 of 78: 15% vs. 0 of 100 for noncardiac sites: p CONCLUSIONSFor nonpenetrating, low-energy chest blows to cause sudden death, impact must occur directly over the heart. Initiation of VF may be mediated by an abrupt and substantial increase in intracardiac pressure. Prevention of sudden death from chest blows during sports requires that protective equipment be designed to cover all portions of the chest wall that overlie the heart, even during body movements and positional changes that may occur with athletic activities. IS - 2 JF - Journal of the American College of Cardiology EP - 654 TI - Impact directly over the cardiac silhouette is necessary to produce ventricular fibrillation in an experimental model of commotio cordis VL - 37 SP - 649 KW - commotio-cordis AU - Link, Mark AU - Maron, Barry AU - Vanderbrink, Brian AU - Takeuchi, Masaaki AU - Pandian, Natesa AU - Wang, Paul AU - Estesiii, Mark PY - 2001/02// UR - http://dx.doi.org/10.1016/S0735-1097(00)01142-6 ER -