Cardiac arrest & resuscitation
Escalating vs Fixed Energy Defibrillation in Out-of-Hospital Cardiac Arrest Ventricular Fibrillation
An erratum to this article was published (JAMA Netw Open, 1 Dec 2025 ↗)
Authors' conclusion
In this retrospective cohort study of patients experiencing OHCA-VF, both the escalating higher-energy (200-300-360 J) regimen and the fixed low-energy (200-200-200 J) regimen were effective for transient VF termination at first shock, whereas the escalating higher-energy regimens were more likely to maintain termination and restore an organized rhythm.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation (VF) who received at least 1 AED shock, China, 2017–2023782 VF defibrillations
- Participants
- 342 patients
- Exposure
- Escalating higher-energy vs fixed low-energy biphasic AED defibrillation
- Escalating higher-energyn = 218
- Outcome
- Sustained and transient VF termination and establishment of an organized rhythm after defibrillations
Methodological detailsmulticentre (48 cities across China)
- Multicentre (48 cities across China)
Further findings
Transient VF termination at first shock (200 J in both groups)
P = 0.64
VF remaining terminated until next rhythm analysis, first shock
P = 0.68
| Outcome | Escalating higher-energy | Fixed lower-energy | Absolute difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Sustained organized rhythm | 34% | 25% | 9% (2%–16%) | P = 0.008 | |
| Sustained organized rhythm in refractory VF, after second shocks and above (subgroup) | 24% | 13% | 11% (3%–19%) | P = 0.008 | |
| Sustained organized rhythm in refractory VF, after third shocks and above (subgroup) | 35% | 18% | 17% (5%–27%) | P = 0.003 | |
| −2002040Difference (linear scale) |
Original publication
Escalating vs Fixed Energy Defibrillation in Out-of-Hospital Cardiac Arrest Ventricular Fibrillation. JAMA Netw Open. Published 1 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →