Double simultaneous defibrillators for refractory ventricular fibrillation

Out-of-hospital cardiac arrest is a leading cause of death in the United States. Ventricular fibrillation (VF) is the most common initial rhythm after cardiac arrest.

To describe a novel approach to the patient with intractable VF after cardiac arrest.

A 51-year old man presented in cardiac arrest after a ST-elevation myocardial infarction. He remained in VF despite receiving typical therapy including cardiopulmonary resuscitation, amiodarone, lidocaine, epinephrine, and five attempts at defibrillation with 200 J using a biphasic defibrillator. VF was eventually terminated with 400 J by the simultaneous use of two biphasic defibrillators. The patient had a full recovery.

We present a case and supportive literature for a novel treatment of high-energy defibrillation in a patient with refractory VF.