Zeh E, Rahner E
Z Kardiol. 1978 Apr;67(4):299-304.
The findings of the manual extrathoracal stimulation of the heart (precordial thump) among 50 persons, healthy individuals and patients with pacemakers, are reported. By all persons it was possible either to cause "extrasystoles" through single blows or to maintain a continuous heart action through a rhythmic stimulation up to 6 minutes ("Temporary stimulation"). Through a manual overstimulation the basic rhythm could be blocked out. -To induce a depolarisation through a thump the locally induced pressure or tension on the heart muscle is of primary importance. For this to occur, the precordial chest thump must develop a rise in pressure of at least 15 to 20 mm Hg in the right ventricle. The location at which the precordial thump can best be effective is on the left border of the sternum in the lower third. That is the region where the heart (right ventricle) is nearest to the chest wall. -Subjective or objective side effects were not observed during our investigations and--in particular--there were no ectopic rhythm or conduction disturbance. -The precordial thump is of importance not only as "initial blow" at the beginning of cardiac resuscitation but also in form of the temporary stimulation in various causes of asystole. It was demonstrated that the manual stimulation of the heart has the same effect as the electrical stimulation and can be used by certain patients by themselves.
报告了对50人（包括健康个体和安装起搏器的患者）进行心脏胸外手动刺激（心前区捶击）的结果。所有人都可以通过单次捶击诱发“早搏”，或者通过有节奏的刺激维持长达6分钟的持续心脏活动（“临时刺激”）。通过手动过度刺激，可以阻断基本节律。——通过捶击诱发去极化时，局部作用于心肌的压力或张力至关重要。为此，心前区捶击必须使右心室压力至少升高15至20毫米汞柱。心前区捶击最有效的位置是胸骨左缘下三分之一处。该区域是心脏（右心室）最靠近胸壁的部位。——在我们的研究过程中未观察到主观或客观的副作用，尤其是没有异位节律或传导障碍。——心前区捶击不仅在心脏复苏开始时作为“初始捶击”很重要，而且在各种心脏停搏原因中以临时刺激的形式也很重要。已证明，手动心脏刺激与电刺激具有相同的效果，某些患者可以自行使用。
