Beyond the Limit: Double Sequential Defibrillation as an Alternative Therapy for Refractory Ventricular Fibrillation

Dennis Miraglia,Lourdes A Miguel,Wilfredo Alonso

doi:10.12691/ajmcr-7-12-6

Dennis Miraglia, Lourdes A Miguel + Show 1 more

Open Access

https://doi.org/10.12691/ajmcr-7-12-6

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Journal: American Journal of Medical Case Reports	Publication Date: Oct 8, 2019
Citations: 3	License type: cc-by

Abstract

The incidence of out-of-hospital cardiac arrest (OHCA) reported from the Resuscitation Outcomes Consortium (ROC) and the CARES registry in 2016 suggests that 110.8 individuals per 100,000 population or 347,000 adults annually suffer from OHCA in the United States (US); likewise, the incidence of in-hospital cardiac arrest (IHCA) reported by Get With The Guidelines-Resuscitation (GWTG-R) suggests that each year, 209,000 people are treated for IHCA. Double sequential defibrillation (DSD) has been proposed as an alternative treatment for refractory ventricular fibrillation (VF) as there appears to be a trend of promising outcomes, including termination of refractory VF, sustained ROSC, increased short term survival and favorable outcomes to hospital discharge. We report a case of prolonged resuscitation of an 72-year-old man who developed pulseless ventricular tachycardia (pVT) that progressed to refractory VF terminated by DSD. In addition, we provide a quick reference that summarizes the characteristics and resuscitative parameters of the reported case.

Highlights

Despite significant advances in resuscitative medicine in recent decades, out-of-hospital cardiac arrest (OHCA) remains a leading cause of death, accounting for up to 1 death per 1,000 population worldwide
Double sequential defibrillation (DSD) is an approach that has been proposed as an alternative treatment for refractory ventricular fibrillation (VF) as there appears to be a trend of promising outcomes, including termination of refractory VF, sustained ROSC, increased short term survival and favorable outcomes to hospital discharge [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]
We report a case of prolonged resuscitation of an 72-year-old man who developed pulseless ventricular tachycardia that progressed to refractory VF terminated by DSD

Summary

Introduction

Despite significant advances in resuscitative medicine in recent decades, out-of-hospital cardiac arrest (OHCA) remains a leading cause of death, accounting for up to 1 death per 1,000 population worldwide. The incidence of OHCA reported from the Resuscitation Outcomes Consortium (ROC) and the Cardiac Arrest Registry to Enhance Survival (CARES), in 2016, suggests that 110.8 individuals per 100,000 population, or 356,500 people of any age or 347,000 adults annually suffer from emergency medical services (EMS) assessed OHCA in the United States (US) [1,2]. The incidence of in-hospital cardiac arrest (IHCA) reported by Get With The Guidelines-Resuscitation (GWTG-R) suggests that each year, 209,000 people are treated for IHCA [3]. Cardiopulmonary resuscitation (CPR) and early defibrillation are the most effective treatment for cardiac arrest patients, who present, shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) [4,5,6]. We report a case of prolonged resuscitation of an 72-year-old man who developed pulseless ventricular tachycardia (pVT) that progressed to refractory VF terminated by DSD. We provide a quick reference that summarizes the characteristics and resuscitative parameters of the reported case

Case Presentation

Findings

Discussion

Conclusion