Double simultaneous defibrillators for refractory ventricular fibrillation.
BACKGROUND
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.


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


METHODS
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.


CONCLUSIONS
We present a case and supportive literature for a novel treatment of high-energy defibrillation in a patient with refractory VF.
Emergency Physicians of St. Louis, St. Louis, Missouri.
Benjamin W
BW
Leacock
D047548:Defibrillators; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy*
cardiac arrest; cardioversion; defibrillation; myocardial infarction; ventricular fibrillation