First Report of Survival in Refractory Ventricular Fibrillation After Dual-Axis Defibrillation and Esmolol Administration.
There is a subset of patients who suffer a witnessed ventricular fibrillation (VF) arrest and despite receiving reasonable care with medications (epinephrine and amiodarone) and multiple defibrillations (3+ attempts at 200 joules of biphasic current) remain in refractory VF (RVF), also known as electrical storm. The mortality for these patients is as high as 97%. We present the case of a patient who, with a novel approach, survived RVF to outpatient follow up.
St. Mary Mercy Hospital, Departments of Graduate Medical Education and Emergency Medicine, Livonia, Michigan; Michigan State University, College of Osteopathic Medicine, Department of Osteopathic Medical Specialties, East Lansing, Michigan.
Kevin M
KM
Boehm
St. Mary Mercy Hospital, Departments of Graduate Medical Education and Emergency Medicine, Livonia, Michigan; Michigan State University, College of Osteopathic Medicine, Department of Osteopathic Medical Specialties, East Lansing, Michigan.
Daniel C
DC
Keyes
St. Mary Mercy Hospital, Departments of Graduate Medical Education and Emergency Medicine, Livonia, Michigan.
Laura E
LE
Mader
St. Mary Mercy Hospital, Departments of Graduate Medical Education and Emergency Medicine, Livonia, Michigan.
J Michelle
JM
Moccia
D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation; D004554:Electric Countershock / Q000379:methods*; D004837:Epinephrine / Q000627:therapeutic use; D006323:Heart Arrest; D006801:Humans; D011412:Propanolamines / Q000008:administration & dosage*; D014693:Ventricular Fibrillation / Q000188:drug therapy
D058671:Adrenergic beta-1 Receptor Antagonists; D000318:Adrenergic beta-Agonists; D011412:Propanolamines; C036604:esmolol; D004837:Epinephrine