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A Case Series of Double Sequence Defibrillation.

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    PubMed
    Summary

    Double Simultaneous Defibrillation (DSD) shows promise for treating refractory ventricular fibrillation (RVF), with over half of patients converting and over a quarter surviving to discharge. Further research is needed to confirm improved survival rates compared to standard methods.

    Keywords:
    cardiac arrestdefibrillationdouble defibrillationdouble sequence defibrillationventricular fibrillation

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    Area of Science:

    • Cardiology
    • Emergency Medicine
    • Critical Care

    Background:

    • Refractory ventricular fibrillation (RVF) presents a significant challenge in emergency cardiac care.
    • Standard defibrillation techniques have limitations in achieving sustained return of spontaneous circulation (ROSC).
    • Double Simultaneous Defibrillation (DSD) utilizes two defibrillators at maximal energy settings in anterior-posterior and anterior-lateral positions.

    Purpose of the Study:

    • To evaluate the effectiveness of Double Simultaneous Defibrillation (DSD) in a large EMS system.
    • To determine ROSC and survival rates in patients with RVF treated with DSD.
    • To assess neurological outcomes in patients receiving DSD.

    Main Methods:

    • A retrospective case series was conducted from January 1, 2015, to April 30, 2015.
    • Physicians instructed paramedics to use DSD after three refractory episodes of ventricular fibrillation (VF).
    • Data collected included patient demographics, resuscitation times, number of shocks, and survival outcomes.

    Main Results:

    • Seven patients received DSD, with a mean age of 62 years.
    • VF converted after DSD in 57.1% of cases (5 out of 7 patients).
    • Survival to discharge with good neurological function was achieved in 28.6% of patients (3 out of 7).

    Conclusions:

    • DSD demonstrated a significant conversion rate from VF in this case series.
    • Potential reasons for improved conversion include multiple defibrillation vectors and increased energy delivery.
    • Further research is warranted to establish DSD's superiority over standard defibrillation for improved survival in RVF.