Abstract 17799: Development and Validation of a Mechanical Surrogate to Assess the Ability of Chest Protectors to Prevent Commotio Cordis, Sudden Cardiac Death With Chest Wall Impact
Introduction: Commotio cordis is one of the leading causes of SCD on the playing field. Chest protection has not been demonstrated to prevent these SCDs.
Hypothesis: A mechanical surrogate to assess for chest wall protection is feasible.
Methods: An experimental commotio cordis model was utilized to assess mechanical variables that predicted for ventricular fibrillation (VF) with chest wall impact. Peak LV pressure, impact force, impulse, chest compression, compression rate, viscous criterion, momentum, energy, force*compression, and impact power were analyzed for the prediction of VF. Further data from post-mortem human specimens were incorporated into a mechanical surrogate, and this surrogate was utilized to assess and develop a standard for chest wall protectors. This mechanical surrogate was then independently validated with chest protector data from the original experimental model.
Results: Of all variables assessed, force was the most robust at predicting for initiation of VF and force attenuation for reduction in risk with placement of a chest wall protector. Average forces with an unprotected chest were 615 N and 1442 N with 30 mph and 50 mph lacrosse balls respectively. With 30 mph impacts force attenuation to less than 400 N reduced VF while at 50 mph force attenuation to less than 800 N reduced the risk of VF. In the validation of the surrogate, two of the materials which reduced the incidence of VF in the experimental model from 62% to less than 5%, were the only materials that reduced force to under 400 N and 800 N at 30 and 50 mph respectively in the surrogate. The R-value comparing the experimental model to the mechanical surrogate was 0.886 (p=0.0017).
Conclusion: An effective surrogate for commotio cordis has been built. This surrogate was based on physiologic data from a well-established experimental model. Adoption of this surrogate will allow effective testing of chest wall protectors, resulting in safeguarding our children on the playing field.
Author Disclosures: E. McCalley: None. N. Dau: None. K.R. Kumar: None. S.N. Mandleywala: None. C. Bir: None. D. Halstead: None. M.S. Link: Research Grant; Significant; NOCSAE.
- © 2016 by American Heart Association, Inc.