Commotio Cordis, Sudden Death Due to Innocent Chest Wall Impact: Role of Potassium Ion Channels in Susceptibility of Individual Athletes.

Principle Investigator: Mark S. Link, M.D., Associate Professor of Medicine

Institution: Tufts University School of Medicine

Title: Commotio Cordis, Sudden Death Due to Innocent Chest Wall Impact: Role of Potassium Ion Channels in Susceptibility of Individual Athletes

Abstract:
Sudden death due to low energy chest wall trauma, commotio cordis, is seen in young athletes aged 5 to 18. Although not common, it is the most frequent cause of death in the young baseball player. Commotio cordis is also reported in hockey, lacrosse, and with bodily contacts in other sports. Death is swift and unusually recalcitrant to even immediate resuscitation efforts. We have developed a swine model with low energy chest wall impact gated to the cardiac cycle. With this model we have found that if an impact occurs during a 20-ms window during repolarization (regeneration of the heart beat) a fatal ventricular arrhythmia can result. Additional insights gained from this model include the importance of location of impact, energy of impact, hardness of impact object, and shape of impact object. Furthermore, this model has been utilized to evaluate safety baseballs and chest wall protectors. And finally this model has provided basic data to the Wayne State Group (Cindy Bir – NOCSAE Funded 2007)  which will be utilized to develop a surrogate mechanical model of commotio cordis, which may then be used to evaluate commercial chest wall protectors.

We have speculated that there is individual susceptibility of humans to chest impact induced sudden cardiac death. Thousands of kids are struck in the chest during sports, and yet only 15 to 20 die per year. We have observed this individual susceptibility in our swine model and wish to explore this hypothesis more fully.

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