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Cardiovascular Research 2001 50(2):280-289; doi:10.1016/S0008-6363(01)00194-8
© 2001 by European Society of Cardiology
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Copyright © 2001, European Society of Cardiology

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

Peter Kohl*, Alex D. Nesbitt, Patricia J. Cooper and Ming Lei

University Laboratory of Physiology, Parks Road, Oxford OX1 3PT, UK

* Corresponding author. Fax: +44-1865-272-554 peter.kohl{at}physiol.ox.ac.uk

Moderate pre-cordial mechanical impact can cause sudden cardiac death, even in the absence of morphological damage to the heart. This is the most severe expression of a condition termed, in the 19th century, Commotio cordis. Experimental studies performed in the early 1930s showed that sudden cardiac death after chest impact is brought about by an intrinsic cardiac response 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 established concept of cardiac mechano—electric feedback. As a result, an explanation of the mechanisms that give rise to sudden cardiac death by Commotio cordis and targets for further research are suggested.

KEYWORDS SCD, sudden cardiac death; MEF, mechano—electric feedback; VT, ventricular tachycardia VF, ventricular fibrillation; K+ATP, ATP-dependent K+ channel

1 Another group of ion channels, frequently assumed to be mechano-sensitive, is constituted by cell volume-activated channels. These channels tend to be selective for either Cl– or K+. Contrary to stretch-activated channels, they require an increase in cytosolic volume for their activation and are not usually affected by direct stretch. They are unlikely, therefore, to form a major substrate for Commotio cordis-induced changes in cardiac electrophysiology. For more detail see the reviews in Refs. [37–39].


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