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Damar Hamlin may have suffered heart arrhythmia, experts say

The Washington Post 1/3/2023 Lenny Bernstein

Buffalo Bills safety Damar Hamlin tackles Cincinnati Bengals wide receiver Tee Higgins during Monday’s game in Cincinnati.

The blow to the chest of Buffalo Bills safety Damar Hamlin may have thrown his heart’s pumping mechanism out of rhythm, disrupting blood flow to his brain and causing his on-field collapse, two experts said Monday night.

Early Tuesday, the Bills announced that he had suffered a cardiac arrest but that his heartbeat was restored on the field before he was taken to a hospital.

Two cardiologists, emphasizing that they could only speculate after watching video footage of the play, said the contact may have caused ventricular fibrillation, the rapid and disorganized contraction of the heart’s lower chambers that disrupts the normal pumping of blood around the body.

That process is governed by carefully timed electrical signals that may have been disturbed by the blow to Hamlin’s chest, they said. The quickest way to return his heart to normal rhythm would be to shock him with an automated external defibrillator, which also would detect the abnormal rhythm, they said.

“The focus is on restoring the electrical synchrony … putting him back into a normal rhythm,” said Rajesh Dash, an associate professor in cardiovascular medicine at Stanford University School of Medicine.

Donations to Damar Hamlin’s community toy drive pass $3.5 million

If Hamlin were particularly unlucky, the blow may have come during an especially vulnerable moment in the heart’s electrical cycle, triggering a condition known as “commotio cordis,” according to Gregory Marcus, a cardiologist and professor of medicine at the University of California at San Francisco.

That window is only 40 milliseconds long, making the condition rare. It most often occurs when young baseball or hockey players receive a blow from a baseball or hockey puck to the center of their chests.

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While an arrhythmia is the most likely cause of the injury that left Hamlin in critical condition, it is not the only possibility, Dash and Marcus said. The violent contact could have caused a bulge in a blood vessel — known as an aneurysm — to burst, or it may have combined with a previously undetected heart defect to trigger a life-threatening event, among other possibilities, they said.

Now the critical question is how long Hamlin’s brain went without the oxygen carried to organs by blood flow, Marcus said. Brain tissue dies quickly when deprived of oxygen.

Medical personnel at the game between the Bills and the Cincinnati Bengals performed cardiopulmonary resuscitation, or CPR, on Hamlin, pressing repeatedly and rapidly on his chest to take over for his heart and pump blood through his system.

It remains to be seen how effective that effort was. According to the website of the Centers for Disease Control and Prevention, “about 9 in 10 people who have cardiac arrest outside the hospital die. But CPR can help improve those odds. If it is performed in the first few minutes of cardiac arrest, CPR can double or triple a person’s chance of survival.”

Marcus said the high death rate cited by the CDC most likely includes many older people with other serious diseases that lead to cardiac arrest. As a young, healthy athlete, Hamlin’s odds are probably better, he said.

Hamlin, who is in critical condition in a Cincinnati hospital, also faces the risk that his heart may slip out of normal rhythm again, Dash said.

“It’s a sensitive time, it could change at any moment,” he said.

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Damar Hamlin may have suffered heart arrhythmia, experts say

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