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Sudden cardiac arrest associated with application of shocks from a TASER Electronic Control Device
Abstract
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fibrosis was enhanced in T1DM animals compared to controls (LA p<0.05; RA p<0.01). Conclusion: T1DM may have an important role in mediating atrial structural and electrophysiological changes to facilitate the presence of a vulnerable substrate for atrial fibrillation. http://dx.doi.org/10.1016/j.hlc.2015.06.283 283 Sudden cardiac arrest associated with application of shocks from a TASER Electronic Control Device J. England 1,∗ , W. Brown 2 , J. Dearin 3 1 Blue Mountains District Anzac Memorial Hospital, Australia 2 Katoomba Police, Australia 3 Lithgow General Medical Practice, Australia
The safety of TASER Electronic Control Devices has been questioned. Underlying coronary artery disease and cardiomyopathy predispose an individual to ventricular arrhythmia. TASER discharges have been shown to produce cardiac stimulation at 220bpm in pacemaker recipients’ interrogation of their devices. A vulnerable 56-year-old male with known multivessel coronary disease suffered deployment of a taser weapon with probes lodged over torso and left diaphragm area. He was immediately subdued with probable ventricular tachycardia before recorded ventricular fibrillation cardiac arrest and DC shock resuscitation. He was known to have a thin walled left ventricle with an ejection fraction of 15% on the basis of previous myocardial infarction and mitral incompetence. He went into acute pulmonary oedema and required intubation, Amiodarone and eventually an AICD. Dr Douglas Zipes (circulation 2014) analysed 8 cases of cardiac arrest/death after shocks from a TASER X26 electronic control device (ECD). His opinion was that ECD stimulation can cause electric capture and provoke cardiac arrest resulting from VT/VF, also based on animal data. He did not condemn ECD use but he wanted to make law enforcement officers aware that ECD use can cause cardiac arrest. When TASERs are deployed an ambulance should be summoned (2010 Commission Perth, W.A) and police officers should be trained in cardiac massage and deployment of any available automated external defibrillator. Survival of out-of-hospital cardiac arrest requires a rapid response time. All emergency personnel should be trained in both CPR and use of an Automatic External Defibrillator. http://dx.doi.org/10.1016/j.hlc.2015.06.284
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284 The effect of different rates of weight gain on atrial electrophysiology D. Twomey ∗ , R. Mahajan, S. Thanigaimani, S. Willoughby, A. Rajwani, D. Lau, P. Sanders Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Australia Introduction: Worsening obesity is associated with increasing atrial fibrosis, inflammation and AF burden. The effect of obesity duration is unknown. We examined the effect on atrial electrophysiology of the same weight gain at different rates. Methods: A total of 21 sheep were studied. A high calorie diet was used in 14 animals to increase weight by 30%. Weight gain was over 60 weeks in 7 animals (slow weight gain) and 20 weeks in 7 animals (rapid weight gain). The remaining 7 animals were lean controls. Electrophysiological testing, cMRI and plasma analysis were performed at the end of the study period. Conduction velocity (CV) was measured using electroanatomical mapping. Effective refractory periods (ERP) were recorded at 8 sites. AF inducibility was tested with a burst pacing protocol. Results: Results are summarised in the table. AF burden was increased in both weight gain groups when compared with controls. The inducibility of AF was significantly higher in the slow weight gain group. The duration of AF was no different between obese groups. LAA ERP reduced with slow weight gain but not with rapid gain. CV reduced equally in both weight gain groups. IL-6 levels were similarly elevated in both obese groups. Intracardiac volumes and pressures showed no significant change with weight gain. Conclusions: Similar weight gain over a longer period appears to increase AF inducibility. This may be due to reduction in ERP over time. Reduction in atrial conduction velocity occurs in short-term weight gain and plateaus in the longer term.
http://dx.doi.org/10.1016/j.hlc.2015.06.285
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fibrosis was enhanced in T1DM animals compared to controls (LA p<0.05; RA p<0.01). Conclusion: T1DM may have an important role in mediating atrial structural and electrophysiological changes to facilitate the presence of a vulnerable substrate for atrial fibrillation. http://dx.doi.org/10.1016/j.hlc.2015.06.283 283 Sudden cardiac arrest associated with application of shocks from a TASER Electronic Control Device J. England 1,∗ , W. Brown 2 , J. Dearin 3 1 Blue Mountains District Anzac Memorial Hospital, Australia 2 Katoomba Police, Australia 3 Lithgow General Medical Practice, Australia
The safety of TASER Electronic Control Devices has been questioned. Underlying coronary artery disease and cardiomyopathy predispose an individual to ventricular arrhythmia. TASER discharges have been shown to produce cardiac stimulation at 220bpm in pacemaker recipients’ interrogation of their devices. A vulnerable 56-year-old male with known multivessel coronary disease suffered deployment of a taser weapon with probes lodged over torso and left diaphragm area. He was immediately subdued with probable ventricular tachycardia before recorded ventricular fibrillation cardiac arrest and DC shock resuscitation. He was known to have a thin walled left ventricle with an ejection fraction of 15% on the basis of previous myocardial infarction and mitral incompetence. He went into acute pulmonary oedema and required intubation, Amiodarone and eventually an AICD. Dr Douglas Zipes (circulation 2014) analysed 8 cases of cardiac arrest/death after shocks from a TASER X26 electronic control device (ECD). His opinion was that ECD stimulation can cause electric capture and provoke cardiac arrest resulting from VT/VF, also based on animal data. He did not condemn ECD use but he wanted to make law enforcement officers aware that ECD use can cause cardiac arrest. When TASERs are deployed an ambulance should be summoned (2010 Commission Perth, W.A) and police officers should be trained in cardiac massage and deployment of any available automated external defibrillator. Survival of out-of-hospital cardiac arrest requires a rapid response time. All emergency personnel should be trained in both CPR and use of an Automatic External Defibrillator. http://dx.doi.org/10.1016/j.hlc.2015.06.284
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284 The effect of different rates of weight gain on atrial electrophysiology D. Twomey ∗ , R. Mahajan, S. Thanigaimani, S. Willoughby, A. Rajwani, D. Lau, P. Sanders Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Australia Introduction: Worsening obesity is associated with increasing atrial fibrosis, inflammation and AF burden. The effect of obesity duration is unknown. We examined the effect on atrial electrophysiology of the same weight gain at different rates. Methods: A total of 21 sheep were studied. A high calorie diet was used in 14 animals to increase weight by 30%. Weight gain was over 60 weeks in 7 animals (slow weight gain) and 20 weeks in 7 animals (rapid weight gain). The remaining 7 animals were lean controls. Electrophysiological testing, cMRI and plasma analysis were performed at the end of the study period. Conduction velocity (CV) was measured using electroanatomical mapping. Effective refractory periods (ERP) were recorded at 8 sites. AF inducibility was tested with a burst pacing protocol. Results: Results are summarised in the table. AF burden was increased in both weight gain groups when compared with controls. The inducibility of AF was significantly higher in the slow weight gain group. The duration of AF was no different between obese groups. LAA ERP reduced with slow weight gain but not with rapid gain. CV reduced equally in both weight gain groups. IL-6 levels were similarly elevated in both obese groups. Intracardiac volumes and pressures showed no significant change with weight gain. Conclusions: Similar weight gain over a longer period appears to increase AF inducibility. This may be due to reduction in ERP over time. Reduction in atrial conduction velocity occurs in short-term weight gain and plateaus in the longer term.
http://dx.doi.org/10.1016/j.hlc.2015.06.285