Cough-facilitated conversion of ventricular tachycardia

Coughing has been shown to be helpful in altering the bradycardia and hypotension that may occur after intracoronary injections of contrast medium and can enable a patient to maintain consciousness during episodes of ventricular fibrillation and asystole. This report describes a patient with ischemic heart disease in whom 33 episodes of drug-refractory ventricular tachycardia were converted to normal sinus rhythm after abrupt forceful coughs were performed on command. When the patient was unable to cough as directed, external electric countershock was necessary to terminate the arrhythmia. These findings suggest that the cough may in isolated cases be effective in the conversion of potentially fatal ventricular tachyarrhythmias.