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Related Experiment Videos

Double sequential external shocks for refractory ventricular fibrillation

D H Hoch1, W P Batsford, S M Greenberg

  • 1Cardiac Arrhythmia and Pacemaker Center, St. Francis Hospital, Roslyn, New York 11576.

Journal of the American College of Cardiology
|April 1, 1994
PubMed
Summary
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Double sequential defibrillation shocks effectively treat refractory ventricular fibrillation, a rare complication during electrophysiologic studies. This rapid, external shock technique offers a potentially lifesaving approach for patients unresponsive to standard treatment.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Critical Care Medicine

Background:

  • Refractory ventricular fibrillation (VF) occurs in approximately 0.1% of electrophysiologic studies.
  • Animal research suggests rapid sequential shocks may lower the VF threshold.

Purpose of the Study:

  • To describe a technique for terminating refractory ventricular fibrillation.
  • To evaluate the efficacy of double sequential shocks in patients unresponsive to standard defibrillation.

Main Methods:

  • A case series of five patients experiencing refractory VF during electrophysiologic studies.
  • Delivery of double sequential external shocks, 0.5 to 4.5 seconds apart, using two defibrillators and separate electrode pairs.

Main Results:

Related Experiment Videos

  • Standard defibrillation failed in all five patients.
  • All patients were successfully resuscitated using the double sequential shock technique.

Conclusions:

  • Refractory ventricular fibrillation necessitates readily available defibrillators during electrophysiologic testing.
  • Rapid, double sequential external shocks present a simple, potentially lifesaving method for refractory VF with broad applicability.