[Initial clinical experiences with mechanical heart stimulation].

Rhythmical extrathoracic mechanical stimulation can produce cardiac systoles. The study was designed to determine the usefulness of this procedure in bridging the time gap between the occurrence of asystole or symptomatic bradycardia and the beginning of temporary cardiac pacing or the restoration of a sufficiently high spontaneous heart rate. The mechanical stimulator was used on 31 patients. In 10 patients sufficient circulation with palpable pulse in the femoral artery could be restored. Five patients needed temporary electrical pacing. Five of the patients successfully treated mechanically died within 24h of terminal circulatory collapse or electromechanical dissociation. Five patients could be dismissed from hospital, with only one of them needing permanent cardiac pacing. Twenty of the 21 patients who could not be stimulated mechanically died. Seventeen of those showed electromechanical dissociation when treated with transvenous endocardiac stimulation, three suffered from terminal circulatory collapse. In one patient with an instable thorax sufficient circulation could be obtained by extrathoracic mechanical stimulation. Four patients were not stimulated electrically because of old age and polymorbidity. Problems in using the extrathoracic mechanical stimulation are discussed and compared with endocardiac and extrathoracic electrical stimulation.