Electrocardiographic Effects of the CEW

  • Jeffrey D. Ho

With the advent of the Advanced TASER® M26 followed soon after by the X26 conducted electrical weapons (CEWs), initial concern for any possible physiologic damage was centered in the area of the cardiac conduction system. While this concern has been theoretical, it makes sense from the standpoint that a large number of people, including educated professionals, do not understand the basics of electrical current except what they were taught by their guardian growing up (e.g., don’t stick your finger in the electrical socket or you will kill yourself) or what they have gleaned over the years from literal experience or mass media advertisement (e.g., be careful when working on your roof not to come into contact with the overhead electrical power lines or you will electrocute yourself). What all of these scenarios have in common is that if sudden death from electrical current comes, it arrives in the form of a cardiac arrhythmia. Because of this, the initial focus of research into whether CEWs are causally connected to sudden custodial death was in the cardiac rhythm arena.


Ventricular Fibrillation Cardiac Rhythm Heart Rhythm Cardiac Conduction System Electrocardiographic Effect 
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  1. 1.
    Bell L. On a form of disease resembling some advanced stages of mania and fever, but so contradistinguished from any ordinary observed or described combination of symptoms as to render it probable that it may be overlooked and hitherto unrecorded malady. Am J Insanity, 1849;6:97–127.Google Scholar
  2. 2.
    Di Maio TG and VJM Di Maio. Excited delirium syndrome cause of death and prevention. 1st ed. Boca Raton, FL: Taylor & Francis Group, 2006.Google Scholar
  3. 3.
    American Civil Liberties Union of Southern California. “Pepper spray update: more fatalities, more questions.” Pepper Spray Update, June, 1995. (Accessed November 1, 2005 at
  4. 4.
    Stratton SJ, Rogers C, Brickett K, and G Gruzinski. Factors associated with sudden death of individuals requiring restraint for excited delirium. Am J Emerg Med, 2001;21:187–91.CrossRefGoogle Scholar
  5. 5.
    Eckart RE, Scoville SL, Campbell CL, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Int Med, 2004;141:829–35.PubMedGoogle Scholar
  6. 6.
    Maron BJ, Roberts WC, and SE Epstein. Sudden death in hypertrophic cardiomyopathy: a profile of 78 patients. Circulation, 1982;65:1388–94.PubMedGoogle Scholar
  7. 7.
    Ross DL. Factors associated with excited delirium deaths in police custody. Mod Pathol, 1998;11:1127–37.PubMedGoogle Scholar
  8. 8.
    Reay DT, Fligner CL, Stilwell AD, and J Arnold. Positional asphyxia during law enforcement transport. Am J Foren Med Pathol, 1992;13:90–7.CrossRefGoogle Scholar
  9. 9.
    O’Halloran RL and LV Lewman. Restraint asphyxia in excited delirium. Am J Foren Med Pathol, 1993;13:289–95.CrossRefGoogle Scholar
  10. 10.
    O’Halloran RL and JG Frank. Restraint asphyxia. Am J Foren Med Pathol, 2000;21:420–22.CrossRefGoogle Scholar
  11. 11.
    O’Halloran RL and JG Frank. Asphyxial death during prone restraint revisited: a report of 21 cases. Am J Foren Med Pathol, 2000;21:39–52.CrossRefGoogle Scholar
  12. 12.
    Wetli CV, Mash D, and SB Karch. Cocaine-associated agitated delirium and the neuroleptic malignant syndrome. Am J Emerg Med, 1996;14:425–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Karch SB and BG Stephens. Drug abusers who die during arrest or in custody. J R Soc Med, 1999;92:110–3.PubMedGoogle Scholar
  14. 14.
    Pestaner JP and PE Southall. Sudden death during arrest and phencyclidine intoxication. Am J Foren Med Pathol, 2003;24:119–22.Google Scholar
  15. 15.
    Ruttenber AJ, Lawler-Heavner J, Yin M, Wetli CV, Hearn WL, and DC Mash. Fatal excited delirium following cocaine use: epidemiologic findings provide new evidence for mechanisms of cocaine toxicity. J Forensic Sci, 1997;42:25–31.PubMedGoogle Scholar
  16. 16.
    United States Department of Justice, Office of Justice Programs, National Institute of Justice. “The effective ness and safety of pepper spray.” Research for Practice, April, 2003. (Accessed June 10, 2008 at
  17. 17.
    Chan TC, Vilke GM, Clausen J, et al. The effect of oleoresin capsicum “pepper” spray inhalation on respiratory function. J Foren Sci, 2002;47:299–304.Google Scholar
  18. 18.
    Chan TC, Vilke GM, Neuman T, and JL Clausen. Restraint position and positional asphyxia. Ann Emerg Med, 1998;32:116–8.CrossRefGoogle Scholar
  19. 19.
    Chan TC, Vilke GM, and T Neuman. Reexamination of custody restraint position and positional asphyxia. Am J Foren Med Pathol, 1998;19:201–5.CrossRefGoogle Scholar
  20. 20.
    Chan TC, Neuman T, Clausen J, Eisele J, and GM Vilke. Weight force during prone restraint and respiratory function. Am J Foren Med Pathol, 2004;25:185–9.CrossRefGoogle Scholar
  21. 21.
    Kornblum RN and SK Reddy. Effects of the TASER in fatalities involving police confrontation. J Foren Sci, 1992;37:956–8Google Scholar
  22. 22.
    Glatter K and SB Karch. Positional asphyxia: inadequate oxygen, or inadequate theory? Foren Sci Int, 2004;141:201–2.CrossRefGoogle Scholar
  23. 23.
    Anonymous. “Taser packs potent but brief punch of electricity.” USA Today 3 June 2005, sec A:13.Google Scholar
  24. 24.
    Will JA, Wu JY, Sun H, et al. Can TASERs directly cause ventricular fibrillation? Presented at the meeting of Experimental Biology, April, 2006.Google Scholar
  25. 25.
    Nanthakumar K, Billingsley IM, Masse S, et al. Cardiac electrophysiological consequences of neuromuscular incapacitating device discharges. J Am Coll Cardiol, 2006;48:798–804.PubMedCrossRefGoogle Scholar
  26. 26.
    Dennis AJ, Valentino DJ, Walter RJ, et al. Acute effects of TASER X26 discharges in a swine model. J Trauma, 2007;63:581–90.PubMedCrossRefGoogle Scholar
  27. 27.
    Walter RJ, Dennis AJ, Valentino DJ, et al. TASER X26 discharges in swine produce potentially fatal ventricular arrhythmias. Acad Emerg Med, 2008;15: 66–73.PubMedCrossRefGoogle Scholar
  28. 28.
    McDaniel WC, Stratbucker RA, Nerheim M, and JE Brewer. Cardiac safety of neuromuscular incapacitating defensive devices. PACE, 2005;28(supplement): S284–7.PubMedGoogle Scholar
  29. 29.
    United Press International. “Police use stun gun on 6 year old.” The Washington Times, November 12, 2004. (Accessed November 1, 2005 at
  30. 30.
    Anonymous. Police review policy after tasers used on kids. CNN, November 15, 2004. (Accessed November 1, 2005 at
  31. 31.
    Taser International. Deadly Rhetoric: How the ACLU of Northern California’s Fight Against Law Enforcement Control Tools Endangers Communities. Taser International, 16 February 2006. Available at:
  32. 32.
    TASER International website, Physician FAQ section (monitoring). Accessed on June 9, 2008 at:
  33. 33.
    Wright RK. Electrical Injures. eMedicine. J Balantine, F Talavera, E Legome, J Halamka, and B Brenner (eds.), 2005. (Accessed June 10, 2008 at
  34. 34.
    Ho JD, Reardon RF, and WG Heegaard. Deaths in police custody: an 8 month surveillance study. Annals Emerg Med, 2005;46(suppl):S94.CrossRefGoogle Scholar
  35. 35.
    Levine SD, Sloane CM, Chan TC, et al. Cardiac monitoring of human subjects exposed to the TASER. J Emerg Med, 2007;33:113–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Vilke GM, Sloane S, Levine S, et al. Twelve-lead electrocardiogram monitoring of subjects before and after voluntary exposure to the TASER X26. Am J Emerg Med, 2007;26:1–4.CrossRefGoogle Scholar
  37. 37.
    Ho JD, Miner JR, Lakireddy DR, et al. Cardiovascular and physiologic effects of conducted electrical weapon discharge in resting adults. Acad Emerg Med, 2006;13:589–95.PubMedCrossRefGoogle Scholar
  38. 38.
    Ho J, Dawes D, Calkins H, and M Johnson. Absence of electrocardiographic change following prolonged application of a conducted electrical weapon in physically exhausted adults. Acad Emerg Med, 2007(supplement 1);14:S128–9.CrossRefGoogle Scholar
  39. 39.
    Kim PJ and WH Franklin. Ventricular fibrillation after stun-gun discharge. NEJM, 2005;353:958–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Wu J, Sun H, O'Rourke A, Huebner S, Rahko P, Will J, Webster J. Taser dart-to-heart distance that causes ventricular fibrillation in pigs. IEEE Trans Biomed Eng, 2007;54:503–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Lakkireddy D, Kowalewski W, Wallick A, Verma A, Martin K, Ryschon J, Butany J, Natale A, and P Tchou. Cardiovascular safety profile of electrical stun guns (TASER®): Impact of point of delivery on ventricular fibrillation thresholds. Heart Rhythm 2006;3:S249.CrossRefGoogle Scholar
  42. 42.
    Wu JY, et al. Taser blunt dart-to-heart distance causing ventricular fibrillation in pigs. IEEE TBME under review 2007.Google Scholar
  43. 43.
    Ho JD, Dawes DM, Reardon RF, et al. Echocardiographic evaluation of a TASER-X26 application in the ideal human cardiac axis. Acad Emerg Med, 2008;15:838–844.Google Scholar
  44. 44.
    Nanthakumar K, Billingsley IM, Masse S, et al. Cardiac electrophysiological consequences of neuromuscular incapacitating device discharges. J Am Coll Cardiol, 2006;48:798–804.PubMedCrossRefGoogle Scholar
  45. 45.
    National Institute of Health. “Epinephrine Injection”. US National Library of Medicine, April 1, 2003. (Accessed June 10, 2008 at
  46. 46.
    Dorian P and K Nanthakumar. Reply (to the letter: Electronic control devices and the clinical milieu). J Am Coll Cardiol, 2007;49:732–3.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Emergency Medicine, Hennepin County Medical CenterUniversity of Minnesota Medical SchoolMinneapolisUSA

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