Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis

Ross, Elliot; Redman, Theodore T.; Harper, Stephen; Mapp, Julian G.; Wampler, David; Miramontes, David

doi:10.1016/j.resuscitation.2016.06.011

Cited by 61 publications

(59 citation statements)

References 25 publications

(23 reference statements)

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“…Previously, we reported our experience with DSD in recurrent and refractory shockable rhythms OHCA . Among the authors, there was disagreement over whether or not recurrent and refractory shockable rhythms should be analyzed together.…”

Section: Discussionmentioning

confidence: 99%

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Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

Mapp

Hans

Darrington

et al. 2019

Academic Emergency Medicine

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Objectives: The goal of our study was to determine whether prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT).Methods: This project is a matched case-control study derived from prospectively collected quality assurance/ quality improvement data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest (OHCA) database between January 2013 and December 2015. The cases were defined as OHCA patients with refractory VF/pVT who survived to hospital admission. The control group was defined as OHCA patients with refractory VF/ pVT who did not survive to hospital admission. The primary variable in our study was prehospital DSD. The primary outcome of our study was survival to hospital admission.Results: Of 3,469 consecutive OHCA patients during the study period, 205 OHCA patients met the inclusion criterion of refractory VF/pVT. Using a predefined algorithm, two blinded researchers identified 64 unique cases and matched them with 64 unique controls. Survival to hospital admission occurred in 48.0% of DSD patients and 50.5% of the conventional therapy patients (p > 0.99; odds ratio = 0.91, 95% confidence interval = 0.40-2.1).Conclusion: Our matched case-control study on the prehospital use of DSD for refractory VF/pVT found no evidence of associated improvement in survival to hospital admission. Our current protocol of considering prehospital DSD after the third conventional defibrillation in OHCA is ineffective.

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Section: Discussionmentioning

confidence: 99%

“…There is one case report, three small case series, and two retrospective cohort analyses evaluating the use of DSD in the prehospital setting . However, to date, there have been no matched case–control studies to evaluate the efficacy of prehospital DSD for refractory VF/pVT.…”

Section: Importancementioning

confidence: 99%

Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

Mapp

Hans

Darrington

et al. 2019

Academic Emergency Medicine

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“…1 Indeed, both of the observational studies included in our metaanalysis are at risk of unknowingly including episodes of recurrent VF. 2,4 Neither study reported having reviewed electrocardiogram records to verify the condition and this resulted in a downgrading of their methodological quality. 5 Although we attempted to perform a sub-analysis of cases defined solely as refractory VF, it is possible that both studies are contaminated with a number of recurrent VF cases which could influence the direction and magnitude of benefit of double sequential external defibrillation (DSED).…”

Section: Replymentioning

confidence: 99%

“…1 Unfournately, very little is known about the mechanism of action of DSED to comment on its potential effect in recurrent VF populations. Although some authors suggest that DSED would be less effective for recurrent VF, 4 there are some proposed mechanisms of action of DSED which could in fact be useful for recurrent VF, including: a larger current, lowering of the defibrillation threshold, and a change in the vector of electricity across the myocardium. 5 Successive episodes of recurrent VF are also less responsive to single shock regimes and could therefore benefit from higher energy shocks.…”

Section: Replymentioning

confidence: 99%

‘Reply to:’ Importance of the distinction between recurrent and shock-resistant ventricular fibrillation: Call for a uniform definition of refractory VF

et al. 2019

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“…There are currently no firm guidelines regarding the treatment of refractory VF. Double sequential defibrillation (DSD) is an approach that has been proposed as an alternative treatment for refractory 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 (pVT) that progressed to refractory VF terminated by DSD.…”

Section: Introductionmentioning

confidence: 99%

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

Miraglia¹,

Miguel²,

Alonso³

2019

AJMCR

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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.

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Dual defibrillation in out-of-hospital cardiac arrest: A retrospective cohort analysis

Cited by 61 publications

References 25 publications

Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

Prehospital Double Sequential Defibrillation: A Matched Case–Control Study

‘Reply to:’ Importance of the distinction between recurrent and shock-resistant ventricular fibrillation: Call for a uniform definition of refractory VF

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

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