title: Cardiac effects of electrical stun guns: does position of barbs contact make a difference?
abstract: BACKGROUND
  The use of electrical stun guns has been rising among law enforcement authorities for subduing violent subjects. Multiple reports have raised concerns over their safety. The cardiovascular safety profile of these devices in relationship to the position of delivery on the torso has not been well studied.
  
  
  METHODS
  We tested 13 adult pigs using a custom device built to deliver neuromuscular incapacitating (NMI) discharge of increasing intensity that matched the waveform of a commercially available stun gun (TASER(R) X-26, TASER International, Scottsdale, AZ, USA). Discharges with increasing multiples of output capacitances were applied in a step-up and step-down fashion, using two-tethered barbs at five locations: (1) Sternal notch to cardiac apex (position-1), (2) sternal notch to supraumbilical area (position-2), (3) sternal notch to infraumbilical area (position-3), (4) side to side on the chest (position-4), and (5) upper to lower mid-posterior torso (position-5). Endpoints included determination of maximum safe multiple (MaxSM), ventricular fibrillation threshold (VFT), and minimum ventricular fibrillation induction multiple (MinVFIM).
  
  
  RESULTS
  Standard TASER discharges repeated three times did not cause ventricular fibrillation (VF) at any of the five locations. When the barbs were applied in the axis of the heart (position-1), MaxSM and MinVFIM were significantly lower than when applied away from the heart, on the dorsum (position-5) (4.31 +/- 1.11 vs 40.77 +/- 9.54, P< 0.001 and 8.31 +/- 2.69 vs 50.77 +/- 9.54, P< 0.001, respectively). The values of these endpoints at position-2, position-3, and position-4 were progressively higher and ranged in between those of position-1 and position-5. Presence of ventricular capture at a 2:1 ratio to the delivered TASER impulses correlated with induction of VF. No significant metabolic changes were seen after standard NMI TASER discharge. There was no evidence of myocardial damage based on serum cardiac markers, electrocardiography, echocardiography, and histopathologic findings confirming the absence of significant cardiac effects.
  
  
  CONCLUSIONS
  Standard TASER discharges did not cause VF at any of the positions. Induction of VF at higher output multiples appear to be sensitive to electrode distance from the heart, giving highest ventricular fibrillation safety margin when the electrodes are placed on the dorsum. Rapid ventricular capture appears to be a likely mechanism of VF induction by higher output TASER discharges.
authors: Mid America Cardiology at University of Kansas Hospital, Kansas City, Kansas, USA.
authors: Dhanunjaya
authors: D
authors: Lakkireddy
authors: Donald
authors: D
authors: Wallick
authors: Atul
authors: A
authors: Verma
authors: Kay
authors: K
authors: Ryschon
authors: William
authors: W
authors: Kowalewski
authors: Oussama
authors: O
authors: Wazni
authors: Jagdish
authors: J
authors: Butany
authors: David
authors: D
authors: Martin
authors: Patrick J
authors: PJ
authors: Tchou
mesh_terms: D000818:Animals; D004285:Dogs; D004558:Electric Stimulation / Q000009:adverse effects* / Q000295:instrumentation*; D004566:Electrodes / Q000009:adverse effects; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D005389:Firearms; D006335:Heart Injuries / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D018570:Risk Assessment / Q000379:methods; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000503:physiopathology*