Mechanical stimulation of the heart: its therapeutic value in tachyarrhythmias

This report presents the experience obtained with the use of mechanical stimulation of the heart by external ("chest thump") and internal (stimulation via catheter) means in the treatment of tachyarrhythmias. The chest thump was used primarily for termination of ventricular tachyarrhythmias. Endocardial stimulation of the right and left ventricles and right atrium via catheters was used for both ventricular and supraventricular arrhythmias. The experience reported includes 68 patients, 19 of whom were treated successfully with mechanical stimulation and 49 of whom required other types of treatment. Of the 32 patients with 33 episodes of atrial tachycardia, eight episodes (24%) were treated successfully (three episodes by right atiral stimulation and five by right ventricular stimulation). Of the four patients with five episodes of junctional tachycardia, three episodes (60%) were treated successfully (one episode by right atrial stimulation and two by right ventricular stimulation). Of the 32 patients with ventricular tachycardia who experienced 37 episodes, 15 episodes (41%) were treated successfully (three by right ventricular stimulation, two by left ventricular stimulation, and ten by chest thump). In two of these patients, the thump was applied to an area of paradoxical pulsation.