The most common rhythm observed in commotio cordis cases is ventricular fibrillation (VF). Other arrhythmias such as polymorphic ventricular tachycardia, complete heart block, idioventricular rhythm, atrial fibrillation, ST-segment elevation, T-wave abnormalities were reported. The timing and location of the impact are crucial in the generation of VF in commotio cordis. When the impact occurs directly over the heart within a specific window during the upslope of the T wave in ventricular repolarization, it triggers a rapid increase in left ventricular intracavitary pressure, leading to VF.

• Electrocardiogram (ECG) findings in commotio cordis can vary depending on the timing of the ECG recording and the presence of arrhythmias.
• The most common rhythm observed in commotio cordis cases is ventricular fibrillation (VF). Other arrhythmias were reported, such as:
  • Polymorphic ventricular tachycardia
  • Complete heart block
  • Idioventricular rhythm
  • Atrial fibrillation
  • ST-segment elevation
  • T-wave abnormalities
• The timing and location of the impact are crucial in the generation of VF in commotio cordis. When the impact occurs directly over the heart within a specific window during the upslope of the T wave in ventricular repolarization, it triggers a rapid increase in left ventricular intracavitary pressure, leading to VF.
• It is important to note that ECG findings may not always be abnormal in commotio cordis cases. reported a case of commotio cordis where the patient did not show any arrhythmias and did not receive any resuscitation procedure. The ECG alterations observed in this case improved over time^[1][2][3].