More than a century ago, investigators demonstrated that large electrical stimuli can cause sudden cardiac arrest [1,2]. Direct electrical stimulation of the heart can cause ventricular fibrillation (VF), which is a rapid uncoordinated contraction of the heart muscle that causes a loss of blood flow to the heart, brain, and other tissues. VF rapidly leads to a loss of consciousness which is followed by death unless electrical defibrillation is performed within a few minutes. Many studies have been performed during the past century to investigate the different types and strengths of electrical stimuli that may initiate cardiac arrhythmias [3].
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References
Hoffa M, Ludwig C. Einige neue versuche Ć¼ber herzebewegung. Z Rationelle Med. 1850;9:107ā144.
Prevost JL, Battelli F. Sur quelques effets des dĆ©charges Ć©lectriques sur le coeur des MammifĆØres. Comptes Rendus des Seances, Academi des Sciences. 1899;129:1267ā1268.
Reilly JP. Cardiac sensitivity to electrical stimulation. In: Reilly JP, ed. Applied Bioelectricity: From Electrical Stimulation to Electropathology. New York: Springer; 1998: 194ā239.
Strote J, Range Hutson H. Taser use in restraint-related deaths. Prehosp Emerg Care. OctāDec 2006;10(4):447ā450.
McDaniel WC, Stratbucker RA, Nerheim M, et al. Cardiac safety of neuromuscular incapacitating defensive devices. Pacing Clin Electrophysiol. Jan 2005;28 Suppl 1:S284ā287.
Nanthakumar K, Billingsley IM, Masse S, et al. Cardiac electrophysiological consequences of neuromuscular incapacitating device discharges. J Am Coll Cardiol. Aug 15 2006;48(4):798ā804.
Wu JY, Sun H, O'Rourke AP, et al. Taser dart-to-heart distance that causes ventricular fibrillation in pigs. IEEE Trans Biomed Eng. Mar 2007;54(3):503ā508.
Ho J, Reardon R, Heegaard W. Deaths in police custody: an 8 month surveillance study. Annals Emerg Med. 2005;46 (Suppl) abstract:S94.
Zipes DP, Wellens HJJ. Sudden cardiac death. Circulation. 1998;98:2334ā2351.
Bunch TJ, Hohnloser SH, Gersh BJ. Mechanisms of sudden cardiac death in myocardial infarction survivors: insights from the randomized trials of implantable cardioverter-defibrillators. Circulation. May 8 2007;115(18):2451ā2457.
Lane RE, Cowie MR, Chow AW. Prediction and prevention of sudden cardiac death in heart failure. Heart. May 2005;91(5):674ā680.
Aufderheide T. Etiology, electrophysiology, and myocaridal mechanics of pulseless elecrical activity. In: Paradis NA, Halperin HR, Nowak RM, eds. Cardiac Arrest: The Science and Practice of Resuscitation Medicine. Baltimore, MD, USA: Williams & Wilkins; 1996:320ā337.
Waldecker B, Brugada P, Zehender M, et al. Dysrhythmias after direct-current cardioversion. Am J Cardiol. 1986;57:120ā123.
Deakin CD, Ambler JJ. Post-shock myocardial stunning: a prospective randomised double-blind comparison of monophasic and biphasic waveforms. Resuscitation. Mar 2006;68(3):329ā333.
Khan IA. Atrial stunning: basics and clinical considerations. Int J Cardiol. Dec 2003;92(2ā3):113ā128.
Nichol G, Thomas E, Callaway CW, et al. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300(12):1423ā1431.
Stratton SJ, Rogers C, Brickett K, et al. Factors associated with sudden death of individuals requiring restraint for excited delirium. Am J Emerg Med. May 2001; 19(3):187ā191.
DiMaio TG, DiMaio VJM. Excited Delirium Syndrome Cause of Death and Prevention. Boca Raton: Taylor & Francis; 2006.
Paredes VL, Rea TD, Eisenberg MS, et al. Out-of-hospital care of critical drug overdoses involving cardiac arrest. Acad Emerg Med. Jan 2004;11(1):71ā74.
Park KS, Korn CS, Henderson SO. Agitated delirium and sudden death: two case reports. Prehosp Emerg Care. AprāJun 2001;5(2):214ā216.
Swerdlow C, Kroll M, Williams H, et al. Presenting rhythm in sudden custodial deaths after use of TASERĀ® electronic control device. Heart Rhythm May 2008;5(5):S44.
Orias O, Brooks CM, Suckling EE, et al. Excitability of the mammalian ventricle throughout the cardiac cycle. AJP. 1950;163:272ā282.
Wikswo JP, Jr., Wisialowski TA, Altemeier WA, et al. Virtual cathode effects during stimulation of cardiac muscle: Two-dimensional in vivo experiments. Circ Res. 1991;68:513ā530.
Fozzard HA, Arnsdorf MF. Cardiac Electrophysiology. In: Fozzard HA, Haber E, Jennings RB, et al. eds. The Heart and Cardiovascular Systems: Scientific Foundations. Second Edition ed. New York, NY, USA: Raven Press; 1992.
Pearce JA, Bourland JD, Neilsen W, et al. Myocardial stimulation with ultrashort duration current pulses. Pacing Clin Electrophysiol. Jan 1982;5(1):52ā58.
Fozzard HA, Schoenberg M. Strength-duration curves in cardiac Purkinje fibres: Effects of liminal length and charge distribution. J Physiol. 1972;226:593ā618.
Smyth NP, Tarjan PP, Chernoff E, et al. The significance of electrode surface area and stimulating thresholds in permanent cardiac pacing. J Thorac Cardiovasc Surg. Apr 1976;71(4):559ā565.
Zierhofer CM. Analysis of a linear model for electrical stimulation of axons--critical remarks on the āactivating function conceptā. IEEE Trans Biomed Eng. Feb 2001;48(2):173ā184.
Weiss G. Sur la possibilite de rendre comparables entre eux les apareils servant a l'excitation. Arch Ital de Biol. 1901;35:413ā446.
Lapicque L. Definition experimentale de l'excitation. Comptes Rendus Acad Sci Paris. 1909;67(2):280ā283.
Blair HA. On the intensity-time relations for stimulation by electric currents. II. J Gen Physiol. 1932;15:731ā755.
Irnich W. The fundamental law of electrostimulation and its application to defibrillation. Pacing Clin Electrophysiol. 1990;13:1433ā1447.
Kroll MW. A minimal model of the monophasic defibrillation pulse. Pacing Clin Electrophysiol. Apr 1993;16(4 Pt 1):769ā777.
Walcott GP, Walker RG, Cates AW, et al. Choosing the optimal monophasic and biphasic waveforms for ventricular defibrillation. J Cardiovasc Electrophysiol. Sep 1995;6(9):737ā750.
Luck JC, Grubb BP, Markel ML. Description of the strength-interval relation with external noninvasive pacing. Pacing Clin Electrophysiol. 1990;13:2031ā2037.
Prochaczek F, Galecka J. The effect of suppression of the distortion artifact during transcutaneous pacing on the shape of the QRS complex. Pacing Clin Electrophysiol. 1990;13:2022ā2025.
Altamura G, Toscano S, Bianconi L, et al. Transcutaneous cardiac pacing: Evaluation of cardiac activation. PACE. 1990;13:2017ā2021.
Klein LS, Miles WM, Heger JJ, et al. Transcutaneous pacing: Patient tolerance, strength-interval relations and feasibility for programmed electrical stimulation. Am J Cardiol. 1988;62(16):1126ā1129.
Kelly JS, Royster RL, Angert KC, et al. Efficacy of noninvasive transcutaneous cardiac pacing patients undergoing cardiac surgery. Anesthesiology. May 1989;70(5):747ā751.
Kemnitz J, Winter J, Vester EG, et al. Transcutaneous cardiac pacing in patients with automatic implantable cardioverter defibrillators and epicardial patch electrodes. Anesthesiology. Aug 1992;77(2):258ā262.
Falk RH, Battinelli NJ. External cardiac pacing using low impedance electrodes suitable for defibrillation: A comparative blinded study. J Am Coll Cardiol. 1993;22:1354ā1358.
McEneaney DJ, Cochrane DJ, Anderson JA, et al. Ventricular pacing with a novel gastroesophageal electrode: a comparison with external pacing. Am Heart J. Jun 1997;133(6):674ā680.
Prochaczek FB, Mugica J. Is the new electrode configuration a break point in transcutaneous cardiac pacing tolerance? European J Biomed Tech. 1994;16(3/4):98ā101.
Estes NA, 3rd, Deering TF, Manolis AS, et al. External cardiac programmed stimulation for noninvasive termination of sustained supraventricular and ventricular tachycardia. Am J Cardiol. Jan 15 1989;63(3):177ā183.
Geddes LA, Voorhees WD, 3rd, Babbs CF, et al. Precordial pacing windows. Pacing Clin Electrophysiol. Sep 1984;7(5):806ā812.
Sweeney JD. Skeletal muscle response to electrical stimulation. In: Reilly JP, ed. Electrical Stimulation and Electropathology. New York, NY: Cambridge University Press; 1992:285ā327.
Voorhees CR, Voorhees WD, 3rd, Geddes LA, et al. The chronaxie for myocardium and motor nerve in the dog with chest-surface electrodes. IEEE Trans Biomed Eng. Jun 1992;39(6):624ā628.
Lerman BB, Deale OC. Relation between transcardiac and transthoracic current during defibrillation in humans. CIRCRES. 1990;67:1420ā1426.
Camacho MA, Lehr JL, Eisenberg SR. A three-dimensional finite element model of human transthoracic defibrillation: Paddle placement and size. IEEE Trans Biomed Eng. 1995;42(6):572ā578.
Cranefield PF, Hoffman BF, Siebens AA. Anodal excitation of cardiac muscle. Am J Physiol. 1957;190:383ā390.
Voorhees WD, III, Foster KS, Geddes LA, et al. Safety factor for precordial pacing: minimum current thresholds for pacing and for ventricular fibrillation by vulnerable-period stimulation. Pacing Clin Electrophysiol. 1984;7:356ā360.
McQuillen EN, McQuillen JB. Pain and suffering ā¦ and unconsciousness. Am J Forensic Med Pathol. Jun 1994;15(2):174ā179.
Morady F, Shapiro W, Shen E, et al. Programmed ventricular stimulation in patients without spontaneous ventricular tachycardia. Am Heart J. May 1984;107(5 Pt 1):875ā882.
Brugada PW, Wellens HJJ. Programmed electrical stimulation of the human heart. In: Josephson MEW, Wellens HJJ, ed. Tachycardias-Mechanisms, Diagnosis, Treatment. Philadelphia, PA: Lea & Febiger; 1984:61ā89.
Wit AL, Janse MJ. Ventricular arrhythmias in the acute phase of myocardial ischemia and infarction. The Ventricular Arrhythmias of Ischemia and Infarction: Electrophysiological Mechanisms. Mount Kisco: Futura Publishing Company, Inc.; 1993:161ā266.
Van Fleet JF, Tacker WA. Cardiac damage from transchest and ICD defibrillator shocks. In: Tacker WA, Jr., ed. Defibrillation of the Heart: ICDs, AEDs, and Manual. St. Louis: Mosby-Year Book, Inc; 1994:259ā298.
Tung L. Electrical injury to heart muscle cells. In: Lee RC, Cravalho EG, Burke JF, eds. Electrical Trauma: The Pathophysiology, Manifestation, and Clinical Management. Cambridge: University of Cambridge Press; 1992:361ā400.
Lee RC, Zhang D, Hannig J. Biophysical injury mechanisms in electrical shock trauma. Annu Rev Biomed Eng. 2000;2:477ā509.
Walcott GP, Killingsworth CR, Ideker RE. Do clinically relevant transthoracic defibrillation energies cause myocardial damage and dysfunction? Resuscitation. Oct 2003;59(1):59ā70.
Ideker RE, Dosdall DJ. Can the direct cardiac effects of the electric pulses generated by the TASER X26 cause immediate or delayed sudden cardiac arrest? Am J Forensic Med and Path. 2007;28(4):195ā201.
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Dosdall, D.J., Ideker, R.E. (2009). Cardiac Arrhythmias. In: Ho, J., Kroll, M. (eds) TASERĀ® Conducted Electrical Weapons: Physiology, Pathology, and Law. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-85475-5_9
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