title: Effects of cocaine intoxication on the threshold for stun gun induction of ventricular fibrillation.
abstract: OBJECTIVE
  This study sought to assess cocaine's effects on Taser-induced ventricular fibrillation (VF) threshold in a pig model.
  
  
  BACKGROUND
  Stun guns are increasingly used by law enforcement officials to restrain violent subjects, who are frequently intoxicated with cocaine and other drugs of abuse. The interaction of cocaine and the stun gun on VF induction is unknown.
  
  
  METHODS
  We tested five adult pigs using a custom device built to deliver multiples of standard neuromuscular incapacitating (NMI) discharge that matched the waveform of a commercially available electrical stun gun (Taser X-26, Taser International, Scottsdale, Arizona). The NMI discharges were applied in a step-up and step-down fashion at 5 body locations. End points included determination of maximum safe multiple, minimum VF-inducing multiple, and ventricular fibrillation threshold (VFT) before and after cocaine infusion.
  
  
  RESULTS
  Standard NMI discharges (x1) did not cause VF at any of the 5 locations before or after cocaine infusion. The maximum safe multiple, minimum VF-inducing multiple, and VFT of NMI application increased with increasing electrode distance from the heart. There was a 1.5- to 2-fold increase in these values at each position after cocaine infusion, suggesting decreased cardiac vulnerability for VF. Cocaine increased the required strength of NMI discharge that caused 2:1 or 3:1 ventricular capture ratios at all of the positions. No significant changes in creatine kinase-MB and troponin-I were seen.
  
  
  CONCLUSIONS
  Cocaine increased the VFT of NMI discharges at all dart locations tested and reduced cardiac vulnerability to VF. The application of cocaine increased the safety margin by 50% to 100% above the baseline safety margin.
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.forename: Donald
authors.initials: D
authors.lastname: Wallick
authors.forename: Kay
authors.initials: K
authors.lastname: Ryschon
authors.forename: Mina K
authors.initials: MK
authors.lastname: Chung
authors.forename: Jagdish
authors.initials: J
authors.lastname: Butany
authors.forename: David
authors.initials: D
authors.lastname: Martin
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.forename: William
authors.initials: W
authors.lastname: Kowalewski
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Tchou
mesh_terms: D000818:Animals; D003042:Cocaine / Q000506:poisoning*; D018765:Dopamine Uptake Inhibitors / Q000506:poisoning*; D004556:Electric Injuries / Q000150:complications*; D005260:Female; D005389:Firearms; D006339:Heart Rate; D008297:Male; D013552:Swine; D014693:Ventricular Fibrillation / Q000209:etiology*
chemical_list: D018765:Dopamine Uptake Inhibitors; D003042:Cocaine