Drs. Barbhaiya and Johar wrote excellent expositions on the first documented case of an implantable cardioverter-defibrillator (ICD) shock due to conducted electrical weapon (CEW) discharges (1,2).
To appreciate the rarity of the event, there have been more than 4 million field uses of just the TASER brand (Axon, Scottsdale, Arizona) of CEW.
CEW use reduces the non firearm arrest-related death rate by 59% to 66%, consistent with the two-thirds reduction in firearm fatalities in agencies where CEW use was not overly restricted (3). The 2 key injury studies, covering collectively more 40,000 uses of force, found that the CEW reduced subject injury by 65% to 78% (4).
It is misleading to state that CEW use is associated with asystole. Asystole is the most common cardiac arrest rhythm with drug and alcohol abuse, but it is not inducible with electrical stimulation (5). Hence, any association is artificial.
The editorial suggests a risk of myocardial capture and cites a report of a prison rioter having an asymptomatic elevated heart rate during a CEW discharge to the chest. That was not direct capture but, rather, the result of the pacemaker housing funneling some CEW charge directly into the right ventricle via the pacemaker lead (6).
Of greater concern is the repetition of the myth that humans have ever been electrocuted by a CEW. All present Taser CEWs deliver <2 W, which satisfies the 5 to 7 W allowed by the UL electric fence standard (UL, Northbrook, Illinois), as well as the international (International Electrotechnical Commission, Geneva, Switzerland) and the European (CENELEC, Brussels, Belgium) 2.5-W limit. They also satisfy the CEW-specific American National Standards Institute (Washington, DC) CPLSO-17. All TASER brand CEWs satisfy all relevant electrical safety standards and, thus, neither injury nor electrocution is expected or has ever been confirmed.
Both the report and the editorial cite a series of 8 expert-witnessing cases. What was not cited, however, was the invited case-by-case refutation of those 8 cases and 4 other published anecdotes (7).
Footnotes
Dr. Kroll is a member of Axon’s Scientific and Medical Advisory Board and is on Axon’s corporate board. Drs. Calkins and Luceri are members of Axon’s Scientific and Medical Advisory Board. Dr. Witte has reported that he has no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Case Reportsauthor instructions page.
References
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