Commotio cordis is most often seen in projectile sports (those that involve throwing objects), such as hockey or baseball. People who experience commotio cordis are usually males under the age of 20. Commotio cordis is rare because it involves a hard object, thrown at a high speed, hitting the left side of the chest directly over the heart at the exact moment when the lower chambers of the heart are relaxing after a heartbeat. The impact can make the ventricles contract when they should be resting. This causes a ventricular fibrillation (deadly irregular heart rhythm) and sudden cardiac arrest. Commotio cordis is rarely caused by softer or larger objects, such as tennis balls, soccer balls or footballs.