ROYLE DAVIES GANNON TOTALLYI MPLANTABLEV ENOUS ACCESS DEVICES -2 0Y EARS' EXPERIENCE OF IMPLANTATION IN CYSTIC FIBROSIS PATIENTSAnn RC oll Surg Engl 2008; 90:6 79-684

A Valsalva manoeuvre is probably the mechanism by which our patient initially reverted his rhythm when jumping from a height or firing a shotgun. He brought his electric fence to the hospital and used it to stop a tachycardia. Electrocardiography showed that the fast rhythm persisted for three beats after the shock, implying that the mechanism of action was probably stimulation of the vagus. Our patient's use of the diving reflex and his do it yourself "electric cardioversion" are, however, a little extreme for standard medical teaching.

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