Sudden cardiac death by Commotio cordis: role of mechano-electric feedback

Moderate pre-cordial mechanical impact can cause sudden cardiac death, even in the absence of morphological damage to the heart. This is the most seve re expression of a condition termed, in the 19th century, Commotio cordis. Experimental studies performed in the early 1930s showed that sudden cardia c death after chest impact is brought about by an intrinsic cardiac respons e to the mechanical stimulus. The precise (sub-)cellular mechanisms of this response are still poorly understood. This article summarises experimental findings on the condition and relates them to the more recently establishe d concept of cardiac mechano-electric feedback. As a result, an explanation of the mechanisms that give rise to sudden cardiac death by Commotio cordi s and targets for further research are suggested. (C) 2001 Elsevier Science B.V. All rights reserved.