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Cardiac and skeletal muscle effects of electrical weapons : A review of human and animal studies.Kunz, Sebastian N; Calkins, Hugh; Adamec, Jiri; Kroll, Mark W; [ 1 ] Landspitali Univ Hosp, Dept Forens Pathol, V Baronstig 101, Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Reykjavik, Iceland Show more [ 3 ] Johns Hopkins Med Inst, Baltimore, MD 21205 USA Show more [ 4 ] Ludwig Maximilians Univ Munchen, Inst Forens Med, Munich, Germany Show more [ 5 ] Univ Minnesota, Dept Biomed Engn, Minneapolis, MN USA Show more [ 6 ] Calif Polytech Inst, San Luis Obispo, CA USA (Humana Press, 2018-09-01)Conducted Electrical Weapons (CEWs) are being used as the preferred non-lethal force option for police and special forces worldwide. This new technology challenges an exposed opponent similarly to the way they would be challenged by physical exercise combined with emotional stress. While adrenergic and metabolic effects have been meta-analyzed and reviewed, there has been no systematic review of the effects of CEWs on skeletal and cardiac muscle. A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological cardiac and skeletal muscle effects of CEWs. For skeletal muscle effects, we analyzed all publications providing changes in creatine kinase, myoglobin and potassium. For cardiac effects, we analyzed reported troponin changes and arrhythmias related to short dart-to-heart-distances. Conducted electrical weapons satisfy all relevant electrical safety standards and there are, to date, no proven electrocution incidents caused by CEWs. A potential cardiovascular risk has been recognized by some of the experimental animal data. The effects on the heart appear to be limited to instances when there is a short dart-to-heart-distance. The effect on the skeletal muscle system appears to be negligible. A responsible use of a CEW on a healthy adult, within the guidelines proposed by the manufacturer, does not imply a significant health risk for that healthy adult.