Intracardiac electrocardiographic assessment of precordial TASER shocks in human subjects: A pilot study
| Autor: | James E. Winslow, William P. Bozeman, Jason P. Stopyra, David M. Fitzgerald |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pacemaker Artificial medicine.medical_specialty Taser Pilot Projects Precordial examination 030204 cardiovascular system & hematology Intracardiac injection Pathology and Forensic Medicine Electrocardiography 03 medical and health sciences 0302 clinical medicine Internal medicine Materials Testing Heart rate Humans Medicine Monitoring Physiologic Aged 80 and over Ekg monitoring Equipment Safety business.industry Cardiac silhouette 030208 emergency & critical care medicine General Medicine Middle Aged medicine.disease Precordium Defibrillators Implantable medicine.anatomical_structure Blood pressure Cardiology Feasibility Studies Medical emergency Weapons business Law |
| Zdroj: | Journal of Forensic and Legal Medicine. 52:70-74 |
| ISSN: | 1752-928X |
| Popis: | Background Case reports of cardiac arrest in temporal proximity to Conducted Electrical Weapon(CEW) exposure raise legitimate concerns about this as a rare possibility. In this pilot study, we respectfully navigate the oversight and regulatory hurdles and demonstrate the intra-shock electrocardiographic effects of an intentional transcardiac CEW discharge using subcutaneous probes placed directly across the precordium of patients with a previously implanted intracardiac EKG sensing lead. Methods Adults scheduled to undergo diagnostic EP studies or replacement of an implanted cardiac device were enrolled. Sterile subcutaneous electrodes were placed at the right sternoclavicular junction and the left lower costal margin at the midclavicular line. A standard police issue TASER Model X26 CEW was attached to the subcutaneous electrodes and a 5 s discharge was delivered. Continuous surface and intracardiac EKG monitoring was performed. Results A total of 157 subjects were reviewed for possible inclusion and 21 were interviewed. Among these, 4 subjects agreed and completed the study protocol. All subjects tolerated the 5 s CEW discharge without clinical complications. There were no significant changes in mean heart rate or blood pressure. Interrogation of the devices after CEW discharge revealed no ventricular pacing, dysrhythmias, damage or interference with the implanted devices. Conclusions In this pilot study, we have successfully navigated the regulatory hurdles and demonstrated the feasibility of performing intracardiac EKG recording during intentional precordial CEW discharges in humans. While no CEW-associated dysrhythmias were noted, the size of this preliminary dataset precludes making conclusions about the risk of such events. Larger studies are warranted and should consider exploring variations of the CEW electrode position in relation to the cardiac silhouette. |
| Databáze: | OpenAIRE |
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