Mechanical properties of chest protectors and the likelihood of ventricular fibrillation due to commotio cordis

Sudden death resulting from ventricular fibrillation (VF) caused by a nonpenetrating chest wall impact, known as commotio cordis (CC), is the second leading cause of death among young athletes. To date, seven young athletes wearing chest protectors have died from CC. The purpose of this study was to determine whether a relationship exists between mechanical properties of chest protectors and occurrence of VF, previously determined by Weinstock et al.,using an established swine model. A servo-hydraulic material tester was used to determine properties of the chest protectors, including displacement, permanent deformation, stiffness, and area of pressure distribution. These properties were then compared with the occurrence of VF We found that a decreased proportion of hits resulting in VF was significantly associated (R-2 = 0.59, p = 0.001) with an increase in the area of pressure distribution. These findings are a limited, but crucial, first step in understanding the prevention of this complex and perplexing phenomenon.