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Abstract
The effects of mechanical stimulation of the heart by blows “fair on the breastbone”
are demonstrated in eleven patients. This method is recommended as a routine measure
to re-establish automaticity or to maintain cardiac activity while mouth-to-mouth
breathing is employed and other methods, such as electrical stimulation or the use
of certain pressor amines, are made ready. Blows to the precordium should be tried
even if ventricular fibrillation is suspected. Not only may ventricular fibrillation
be confused with multiple variform ventricular extrasystoles in the electrocardiogram
but it may also be followed by standstill.
The method succeeds in preserving life by evoking ectopic beats which may reawaken
cardiac automatism. In the normal heart mechanical stimulation elicits a single response.
In the altered, damaged or hypoxic myocardium a blow may produce a multiple response
manifested by a tachycardia or even fibrillation.
Experimentally, a prolonged ectopic tachycardia follows mechanical stimulation under
the influence of a variety of substances but particularly in the presence of calcium
deprivation. This effect is best explained by the formation of oscillatory after-potentials
occurring in the wake of a single depolarization.
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© 1960 Published by Elsevier Inc.
