Taser goes wireless, page 2
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reply posted on 11-7-2007 @ 03:31 PM by Tom Bedlam
Originally posted by PaddyInf
This is theoretically possible by causing a direct blunt-force impact to the centre of the chest at this exact moment. The precordial thump that goes in and out of fashion in CPR delivers approx 30 Joules of power to the heart if delivered correcly. If delivered at the wrong time it can caus VF. The chances of this happening are, in reality, very slim.


Commotio is by definition caused by mechanical force.

However, you can do the same thing electrically almost every time. You do, however, have to get the timing exactly right, and the waveforms are very critical.

The end result is to fire a random collection of ventricular fibers that are in their relative refractory period. If you fire too many (too late or too much energy), then they will overdrive the remainder and the heart will re-sync itself after a few PVC's. If you do it too early, then you won't get a large enough recruitment of fibers because too many are still too refractory, and they'll resync in a few beats.

But if you do it just right, then you set up a lot of extraneous ventricular pacing foci that won't entrain with the normal input from the Purkinje fibers, and the erratic nature of the firing leads to a totally uncoordinated ventricular rhythm which doesn't move any blood. The reduction in cardiac oxygenation makes the ventricular fibers even more irritable, and away it goes.

On the EKG it looks a bit like torsades at first, but then it degenerates into Vfib.
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