Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can\nbe the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor\nvehicle accidents or traumatic falls. In this setting, themanifestation of ventricular arrhythmias has been observed both acutely and\nchronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation\ncan occur immediately after chest wall injury (commotio cordis) and requires rapid defibrillation. Monomorphic ventricular\ntachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury.The associated\narrhythmogenic tissue may be complex and provides the necessary substrate to forma reentrant VT circuit. Ventricular tachycardia\nin the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of\nthe VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest\ninjury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and\ntreatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma.
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