Five male patients with recurrent VF were treated with Double. The trial was stopped early by the data and safety monitoring board. Double Sequential Defibrillation was first described in animal literature in the 1980’s in an article presented in the Journal of American Cardiology.1 The first human cardiology mention was from Yale-New Haven Hospital in Connecticut and St. Herein, we describe the successful termination of refractory ven- tricular fibrillation that did not respond to standard. This use of DED occurs after standard transthoracic electrical current from a single defibrillator have failed to terminate this lethal rhythm. The ROSC rates were also similar between the VC and DSED groups at 39. 'The usefulness of double sequential defibrillation for refractory shockable rhythm has not been established.' It is currently not recommended. The VF termination was highest in the VC group at 82 vs 66.6 and 76.3 for the standard and DSED groups respectively. Eligible patients who remained in VF after three consecutive shocks had been delivered received one of three types of defibrillation according to the random assignment for the cluster: standard defibrillation (n = 136) with pads in the original anterior-lateral position VC defibrillation, with pads in the anterior-posterior configuration (n = 144) or DSED, with a second set of defibrillation pads (provided by a second defibrillator) in the anterior-posterior position (n = 125) with a short delay (<1 second) between shocks. The study results seem to support the use of VC to the anterior posterior positioning for refractory VF in the prehospital setting. Because it is practically very difficult to defibrillate at exactly the same. All patients received initial defibrillation according to standard protocol for three defibrillation attempts with pad position anterior-lateral. Dual Sequential Defibrillation (DSD shocks delivered in close sucession). Survival was 30.4 with double sequential, 21.7 with vector change, and 13. ![]() For the primary outcome of survival to hospital discharge, both treatment groups were statistically superior to standard defibrillation. This was a cluster-randomized controlled trial with crossover in six paramedic services in Ontario, Canada. 68 of arrests were witnessed, and 58 received bystander CPR.
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