Sudden Death, Ventricular Fibrillation, Ventricular Defibrillation — Historical Review and Recent Advances

For many centuries, sudden death unrelated to trauma has been recognised as a clinical entity. In the first century A.D. Pliny the Elder studied many citizens of Rome — physicians, senators, and businessmen — who had dropped dead. With no post-mortems, these deaths were usually attributed to ‘an act of the gods’. Frequent records of sudden death were made throughout the Middle Ages and in the seventeenth and eighteenth centuries. In 1560 Lusitanus wrote: ‘A reverend abbot from the Isle of Croma, one or two miles distant from Ragusa, when he was in good health and talking to several persons, said that he suddenly felt pain in his heart and with his hand moved rapidly toward the region of the heart, he fell, though slowly, to the earth and rapidly lost all his animal faculties. When called in I said he was dead. Not only was the pulse at the metacarpium and the temples missing, but even no motion upon the heart could be perceived. In order to satisfy the assistants I brought to the nostrils a burning candle whose flame did not move at all. Also a bright mirror was advanced near the mouth and nothing of respiratory contraction was seen on it. We then applied a glass vessel filled with water upon the thorax but the water was unmoved’. Lancisi [1] performed post-mortems on the citizens of Rome who died suddenly during 1705–1706, and found a natural cause for death in every case and he referred particularly to diseases of the blood vessels with ‘obstruction therefrom of the free flow of blood’.