John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii; and.
John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii; and Kapi'olani Medical Specialists, Hawai'i Pacific Health, Honolulu, Hawaii
Pediatrics. 2015 Jan;135(1):e199-201. doi: 10.1542/peds.2014-1972. Epub 2014 Dec 8.
Low-energy blunt chest trauma can cause commotio cordis and ventricular fibrillation (VF) in otherwise healthy young individuals. If the chest wall impact occurs during a narrow vulnerable window of ventricular repolarization, the generated premature ventricular impulse can lead to VF and sudden death. Atrial fibrillation (AF) in association with a blunt chest trauma has not yet been reported in a child or adolescent. Our case describes a healthy 16-year-old boy who suffered blunt chest trauma during football practice. He was found to have AF, which resolved in 3 days without any therapy. He did not have any identifiable structural or electrical cardiac abnormality and had no previous history of arrhythmia. We hypothesize that AF, similar to commotio cordis-induced VF, may occur as a result of a blunt chest trauma in healthy young individuals. Animal studies evaluating arrhythmias related to chest wall impact may elucidate the timing and mechanism of AF induced by commotio cordis.
低能量钝性胸部创伤可导致健康年轻个体出现震荡性心搏骤停和心室颤动(VF)。如果胸壁撞击发生在心室复极的狭窄易损窗口期间,所产生的过早心室冲动可导致VF 和猝死。在儿童或青少年中,与钝性胸部创伤相关的心房颤动(AF)尚未见报道。我们的病例描述了一名健康的 16 岁男孩,他在足球训练中遭受了钝性胸部创伤。他被发现患有 AF,3 天后无需任何治疗即可自行缓解。他没有任何可识别的结构性或电心脏异常,也没有心律失常的既往病史。我们假设,AF 类似于震荡性心搏骤停引起的 VF,可能是由于健康年轻个体的钝性胸部创伤引起的。评估与胸壁撞击相关的心律失常的动物研究可能阐明震荡性心搏骤停引起的 AF 的时间和机制。