Cardiovascular and Physiologic effects of conducted electrical weapon discharge in resting adults

Objectives: The TASER is a conducted electrical weapon (CEW) that has been used on people in custody. Individuals occasionally die unexpectedly while in custody, proximal to the application of a CEW. In this study, the authors sought to examine the effects of CEW application in resting adult volunteers to determine if there was evidence of induced electrical dysrhythmia or direct cellular damage that would indicate a causal relationship between application of the device and in-custody death. Methods: Human subjects (N = 66) underwent 24-hour monitoring after a standard CEW application. Blood samples were collected before and after exposure and again at 16 and 24 hours after exposure. A subpopulation (n = 32) had 12-lead electrocardiography performed at similar time intervals. Blood samples were analyzed for markers of skeletal and cardiac muscle injury and renal impairment. The electrocardiograms were read by a cardiologist blinded to the study. Data were analyzed using descriptive statistics. Results: There was no significant change from baseline at any of the four time points for serum electrolyte levels and the blood urea nitrogen/creatinine ratio. An increase in serum bicarbonate and creatine kinase levels was noted at 16 and 24 hours. An increase in serum lactate level was noted immediately after exposure that decreased at 16 and 24 hours. Serum myoglobin level was increased from baseline at all three time points. All troponin levels measured were <0.3 ng/mL, except for a single value of 0.6 ng/mL in a single subject. This subject was evaluated, and no evidence of acute myocardial infarction or disability was identified. At baseline, 30 of 32 electrocardiograms were interpreted as normal. The two abnormal electrocardiograms were abnormal at baseline and remained the same at all four time points. Conclusions: In this resting adult population, the TASER X26 CEW did not affect the recordable cardiac electrical activity within a 24-hour period following a standard five-second application. The authors were unable to detect any induced electrical dysrhythmias or significant direct cardiac cellular damage that may be related to sudden and unexpected death proximal to CEW exposure. Additionally, no evidence of dangerous hyperkalemia or induced acidosis was found. Further study in the area of the in-custody death phenomenon to better understand its causes is recommended.