Ventricular Fibrillation Induced by Stretch Pulse: Implications for Sudden Death Due to Commotio Cordis

Bode, Frank; Franz, Michael R.; Wilke, Iris; Bonnemeier, Hendrik; Schunkert, Heribert; Wiegand, Uwe K.H.

doi:10.1111/j.1540-8167.2006.00547.x

Cited by 56 publications

(56 citation statements)

References 39 publications

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“…The activation of mechano-sensitive ion channels can generate premature ventricular depolarization. 5 If the timing of the premature depolarization occurs during a vulnerable period of ventricular repolarization, it may trigger VF. 7,8 Similarly, an increase in atrial pressure and atrial wall stretch can activate mechano-sensitive ion channels and induce AF.…”

Section: Discussionmentioning

confidence: 99%

“…When the impact is directly over the heart and it occurs within a 20-millisecond window during the upslope of T wave in ventricular repolarization, the rapid increase in the left ventricular intracavitary pressure triggers stretch-activated ion channels generating focal ventricular depolarization that propagates to VF. 5,6 Our case report describes a young male adolescent who suffered blunt chest trauma and who developed not VF but atrial fibrillation (AF). This unique case is the first documented description of a child with AF due to suspected commotio cordis.…”

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confidence: 99%

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Atrial Fibrillation Induced by Commotio Cordis Secondary to a Blunt Chest Trauma in a Teenage Boy

Ota

Bratincsák

2015

Pediatrics

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Low-energy blunt chest trauma can cause commotio cordis and ventricular fibrillation (VF) in otherwise healthy young individuals. If the chest wall impact occurs during a narrow vulnerable window of ventricular repolarization, the generated premature ventricular impulse can lead to VF and sudden death. Atrial fibrillation (AF) in association with a blunt chest trauma has not yet been reported in a child or adolescent. Our case describes a healthy 16-year-old boy who suffered blunt chest trauma during football practice. He was found to have AF, which resolved in 3 days without any therapy. He did not have any identifiable structural or electrical cardiac abnormality and had no previous history of arrhythmia. We hypothesize that AF, similar to commotio cordis-induced VF, may occur as a result of a blunt chest trauma in healthy young individuals. Animal studies evaluating arrhythmias related to chest wall impact may elucidate the timing and mechanism of AF induced by commotio cordis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Atrial Fibrillation Induced by Commotio Cordis Secondary to a Blunt Chest Trauma in a Teenage Boy

Ota

Bratincsák

2015

Pediatrics

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“…Описаны случаи внезапной смерти от удара в область сердца кулаком при еди-ноборствах, попадании шайбы, даже снежком в об-ласть сердца, падении грудью или спиной с турника и других обстоятельствах. Сommotio сordis является причиной внезапной смерти у юных спортсменов: от 2% [11] до 20% случаев [3,14]. Анализируя обстоятельства внезапной сердечной смерти у спортсменов по отношению к неспортсме-нам 12 -35 лет, отмечено, что у спортсменов в 89% случаях это событие возникает во время занятий спортом или сразу после, в то время как у неспор-тсменов в 91% случаев оно не связано с какими-ли-бо нагрузками [17].…”

Section: обзоры литературыunclassified

“…крупном исследовании по обсуждае-мой проблеме [1], которое охватило 36% всех юных спортсменов (14)(15)(16)(17)(18) Отчеты об аутопсии были получены в 73% случа-ев. Наиболее распространенными патоморфологиче-скими диагнозами были: идиопатическая желудочко-вая гипертрофия, возможно кардиомиопатия -26%, необъяснимая внезапная смерть (Sudden Unexplained Death, SUD) -18%, гипертрофическая кардиоми-опатия -14% и миокардит -14%, contusion cordis или commotio cordis (см.…”

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“…Особую группу составляют случаи внезапной сердечной смерти при тупых ударах в область серд-ца, выделенные в практике отечественной судебной медицины как смерть от рефлекторной остановки сердца [13], в западной -как ушиб (contusion cordis) или сотрясение (commotio cordis) сердца [14][15][16][17]. Попадание в уязвимую фазу сердечного цикла (на-чало зубца Т на ЭКГ) такой удар запускает фаталь-ные аритмии -фибрилляцию или сразу асисто-лию желудочков.…”

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Sport and sudden death in children

Макаров¹

2017

Ross. vestn. perinatol. pediatr.

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Commotio Cordis

Madias

Link

2016

IOC Manual of Sports Cardiology

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Sudden arrhythmic death as a result of a blunt chest wall blow has been termed Commotio Cordis (CC). CC is being reported with increasing frequency with more than 180 cases now described in the United States Commotio Cordis Registry. The clinical spectrum is diverse; however young athletes tend to be most at risk, with victims commonly being struck by projectiles regarded as standard implements of the sport. Sudden death is instantaneous and victims are most often found in ventricular fibrillation (VF). Chest blows are not of sufficient magnitude to cause any significant damage to overlying thoracic structures and autopsy is notable for the absence of any structural cardiac injury. Development of an experimental model has allowed for substantial insights into the underlying mechanisms of sudden death. In anesthetized juvenile swine, induction of VF is instantaneous following chest impacts that occur during a vulnerable window before the T wave peak. Other critical variables, including the impact velocity and location, and the hardness of the impact object have also been identified. Rapid left ventricular pressure rise following chest impact likely results in activation of ion channels via mechano-electric coupling. The generation of inward current through mechanosensitive ion channels results in augmentation of repolarization and non-uniform myocardial activation, and is the cause of premature ventricular depolarizations that are triggers of VF in CC. Currently available chest protectors commonly used in sport are not adequately designed to prevent CC. The development of more effective chest protectors and the widespread availability of automated external defibrillators at youth sporting events could improve the safety of young athletes.

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Ventricular Fibrillation Induced by Stretch Pulse: Implications for Sudden Death Due to Commotio Cordis

Cited by 56 publications

References 39 publications

Atrial Fibrillation Induced by Commotio Cordis Secondary to a Blunt Chest Trauma in a Teenage Boy

Atrial Fibrillation Induced by Commotio Cordis Secondary to a Blunt Chest Trauma in a Teenage Boy

Sport and sudden death in children

Commotio Cordis

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