Evaluation of the skin-to-heart distance in the standing adult by two-dimensional echocardiography

J Am Soc Echocardiogr. 2008 Jun;21(6):761-4. doi: 10.1016/j.echo.2007.10.027. Epub 2008 Jan 9.

Abstract

Background: An electromuscular incapacitating device (EMD) delivers pulses of high-voltage electricity, causing strong muscle contraction. Data from a pig model suggest that an EMD dart tip placed within 17 mm of the epicardial surface can cause ventricular fibrillation. The current study estimates minimum skin-to-heart distance in the adult, to determine whether individuals might be at risk for ventricular fibrillation from an EMD.

Methods: We performed 2-dimensional echocardiograms in 150 standing adults in the parasternal, apical, and subcostal views. From each view, the shortest linear skin-to-heart distance was measured.

Results: Average skin-to-heart distances were: parasternal 32.1 +/- 7.9 mm; apical 31.3 +/- 11.3 mm; and subcostal 70.8 +/- 22.3 mm. There were 9 (6%) individuals with a skin-to-heart distance less than or equal to 17 mm. The skin-to-heart distance was significantly correlated with body mass index: parasternal r = 0.57, apical r = 0.55 (P < .0001).

Conclusions: An EMD dart penetrating the skin directly over the heart might put individuals at risk for ventricular fibrillation.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Body Mass Index
  • Echocardiography*
  • Electric Stimulation / adverse effects*
  • Electric Stimulation / instrumentation
  • Female
  • Heart* / anatomy & histology
  • Humans
  • Law Enforcement*
  • Male
  • Middle Aged
  • Muscle Contraction
  • Reference Values
  • Risk Factors
  • Skin* / anatomy & histology
  • Skin* / diagnostic imaging
  • Ventricular Fibrillation / diagnostic imaging
  • Ventricular Fibrillation / etiology*