Minimally invasive direct cardiac massage and defibrillation

Direct massage of the heart may be performed using a specifically designed device inserted via a limited thoracic incision. The technique is simple to perform and has been shown in experimental studies to be physiologically s imilar to formal open-chest cardiac massage. Preliminary human studies have been encouraging and pre-hospital and in-hospital studies are in progress. Modification of the device allows combined epicardial-transthoracic defibr illation. Energy requirements for successful defibrillation using this meth od are considerably lower than standard external defibrillation. (C) 2000 E lsevier Science Ireland Ltd. All rights reserved.