title: Cardiac stimulation with electronic control device application.
abstract: BACKGROUND
  Electronic control devices (ECDs) are weapons used to incapacitate violent subjects. Subjects have died suddenly after ECD application, but because cardiac dysrhythmias have been inconsistently observed during ECD application in animals, the cause for death is uncertain.
  
  
  OBJECTIVE
  The objective was to identify the factors contributing to cardiac stimulation during ECD application detected by transesophageal echocardiography.
  
  
  METHODS
  Four Yorkshire pigs were anesthetized, paralyzed with vecuronium, and restrained in a supine position. A GE 6T echo probe was placed in the esophagus to directly visualize left ventricular function. M-mode echocardiography was used to estimate heart rate. Two dart locations, chest and abdomen, were assessed. ECD applications were delivered from one of five commercially available devices (Taser X26, Singer S200 AT, Taser M26, Taser X3, and Taser C2) in random order to each pig, four times in each orientation.
  
  
  RESULTS
  Cardiac stimulation, characterized by multiple PVCs or the sudden increase in ventricular contraction rate during application, did not occur with abdominal dart location. With chest dart application in small pigs, cardiac stimulation occurred with all ECDs except with the Taser X3 (p < 0.0001). In large pigs, cardiac stimulation occurred only during chest application of the S200 AT (chest vs. abdomen: 207 beats/min, vs. 91 beats/min, p < 0.0001).
  
  
  CONCLUSIONS
  Cardiac stimulation occurs during ECD application in pigs, and is dependent upon subject size, dart orientation, and ECD. The Taser X3 did not result in cardiac stimulation in small or large pigs.
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Koerber
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Ardhanari
authors.affiliation: Department of Electrical and Computer Engineering, University of Missouri, Columbia, Missouri.
authors.forename: Wayne C
authors.initials: WC
authors.lastname: McDaniel
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Pawell
authors.initials: P
authors.lastname: Zymek
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Greg
authors.initials: G
authors.lastname: Flaker
mesh_terms: D000818:Animals; D049628:Body Size; D057667:Conducted Energy Weapon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004195:Disease Models, Animal; D017548:Echocardiography, Transesophageal; D004558:Electric Stimulation / Q000009:adverse effects / Q000295:instrumentation; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D013552:Swine
keywords: TASER; cardiac stimulation; dysrhythmia; electronic control device; stun gun