Dual sequential defib8/9/2023 ![]() We report a case of prolonged resuscitation of an 72-year-old man who developed pulseless ventricular tachycardia (pVT) that progressed to refractory VF terminated by DSD. Double sequential defibrillation (DSD) is an approach that has been proposed as an alternative treatment for refractory VF as there appears to be a trend of promising outcomes, including termination of refractory VF, sustained ROSC, increased short term survival and favorable outcomes to hospital discharge 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24. There are currently no firm guidelines regarding the treatment of refractory VF. Mortality rates in patients with refractory VF are high, perhaps because resuscitation lasts longer than 20 minutes and the occurrence of ischemic burden and progressive myocardial dysfunction imposed during resuscitation is significantly higher in these patients 5, 8, 25, 27. Refractory VF is a life-threatening arrhythmia unresponsive to at least three SD attempts and antiarrhythmic medications although, no consensus exists as to a definition of refractory VF in the literature 7. ![]() However, there is a subgroup of patients in which VF remains refractory to standard defibrillation (SD). Cardiopulmonary resuscitation (CPR) and early defibrillation are the most effective treatment for cardiac arrest patients, who present, shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) 4, 5, 6. Likewise, the incidence of in-hospital cardiac arrest (IHCA) reported by Get With The Guidelines-Resuscitation (GWTG-R) suggests that each year, 209,000 people are treated for IHCA 3. The incidence of OHCA reported from the Resuscitation Outcomes Consortium (ROC) and the Cardiac Arrest Registry to Enhance Survival (CARES), in 2016, suggests that 110.8 individuals per 100,000 population, or 356,500 people of any age or 347,000 adults annually suffer from emergency medical services (EMS) assessed OHCA in the United States (US) 1, 2. In addition, we provide a quick reference that summarizes the characteristics and resuscitative parameters of the reported case.ĭespite significant advances in resuscitative medicine in recent decades, out-of-hospital cardiac arrest (OHCA) remains a leading cause of death, accounting for up to 1 death per 1,000 population worldwide. ![]() ![]() ![]() Double sequential defibrillation (DSD) has been proposed as an alternative treatment for refractory ventricular fibrillation (VF) as there appears to be a trend of promising outcomes, including termination of refractory VF, sustained ROSC, increased short term survival and favorable outcomes to hospital discharge. The incidence of out-of-hospital cardiac arrest (OHCA) reported from the Resuscitation Outcomes Consortium (ROC) and the CARES registry in 2016 suggests that 110.8 individuals per 100,000 population or 347,000 adults annually suffer from OHCA in the United States (US) likewise, the incidence of in-hospital cardiac arrest (IHCA) reported by Get With The Guidelines-Resuscitation (GWTG-R) suggests that each year, 209,000 people are treated for IHCA. ![]()
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