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J Emerg Med. 2014 Apr;46(4):472-4. doi: 10.1016/j.jemermed.2013.09.022. Epub 2014 Jan 21.

Double simultaneous defibrillators for refractory ventricular fibrillation.

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1
Emergency Physicians of St. Louis, St. Louis, Missouri.

Abstract

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.

CASE REPORT:

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.

CONCLUSION:

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

KEYWORDS:

cardiac arrest; cardioversion; defibrillation; myocardial infarction; ventricular fibrillation

PMID:
24462025
DOI:
10.1016/j.jemermed.2013.09.022
[Indexed for MEDLINE]
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