title: Emergent precordial percussion revisited--pacing the heart in asystole.
abstract: Precordial percussion is a technique by which a manual force is applied repeatedly to the chest of a patient experiencing an unstable bradycardic or asystolic rhythm. The force is used not to defibrillate the myocardium as is the case with the "precordial thump" in pulseless ventricular tachycardia/ventricular fibrillation but rather to initiate a current through the myocardium in the form of an essentially mechanically paced beat. In this review, we discuss the physiology and utility of precordial percussion, or precordial thump, in the emergency setting as a very temporary bridge to more effective and permanent pacing techniques.
authors.affiliation: Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Monteleone
authors.forename: Kostas
authors.initials: K
authors.lastname: Alibertis
authors.forename: William J
authors.initials: WJ
authors.lastname: Brady
mesh_terms: D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods; D006321:Heart / Q000503:physiopathology; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006336:Heart Massage / Q000379:methods*; D006801:Humans