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J Am Coll Cardiol. 1994 Apr;23(5):1141-5.

Double sequential external shocks for refractory ventricular fibrillation.

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

Abstract

OBJECTIVES:

A technique for terminating refractory ventricular fibrillation is described.

BACKGROUND:

Refractory ventricular fibrillation can occur in up to 0.1% of electrophysiologic studies. Animal studies have shown that rapid sequential shocks may reduce ventricular fibrillation threshold.

METHODS:

Five patients of 2,990 consecutive patients in a 3-year period experienced refractory ventricular fibrillation during 5,450 routine electrophysiologic studies. Multiple shocks were delivered by means of a single defibrillator. Double sequential shocks were delivered externally 0.5 to 4.5 s apart by means of two defibrillators with separate pairs of electrodes.

RESULTS:

In all patients, standard defibrillation was unsuccessful, but all were successfully resuscitated using the double sequential shocks.

CONCLUSIONS:

This report stresses the importance of an additional defibrillator being readily available during electrophysiologic testing. This technique of rapid, double sequential external shocks may have general applicability, providing a simple and potentially lifesaving approach to refractory ventricular fibrillation.

PMID:
8144780
DOI:
10.1016/0735-1097(94)90602-5
[Indexed for MEDLINE]
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