Electrical and mechanical interventions affect cardiac function and may both cause and terminate life-threatening arrhythmias. While electrical energy delivery has developed into the most important tool for clinical heart rhythm management, relatively little is known about mechanical interventions. Manoeuvres, such as intra-thoracic pressure increases (cough-version), or impulse-like mechanical stimulation (pre-cordial thump, fist pacing, intra-cardiac stimulation), bear significant resuscitatory potential as they are instantaneously 'at hand'. However, underlying mechanisms, determinants of safety (avoidance of arrhythmogenicity), and optimal means of application are ill-understood. Nonetheless, mechanical interventions are recommended procedures in the latest guidelines of the International Liaison Committee on Resuscitation (ILCOR 2005). The presentation will review historical observations and recent insight into mechanical induction and termination of arrhythmia in man, highlight benefits and limitations of animal models and lower-level wet experimentation, and illustrate how computational re-integration of data may advance the understanding of potential mechanisms and pathways of responses, to guide safety considerations and future experimental and/or clinical research.