Cardiac arrest & resuscitation
The impact of alternate defibrillation strategies on shock-refractory and recurrent ventricular fibrillation: A secondary analysis of the DOSE VF cluster randomized controlled trial
Authors' conclusion
DSED appears to be the superior defibrillation strategy in the DOSE VF trial, irrespective of whether the preceding VF is shock-refractory or recurrent.
Study context
- Population
- Patients with refractory VF (VF after three successive shocks) in the DOSE VF randomized controlled trial (RCT), categorised as shock-refractory or recurrent VF by shocks 1–360 shock-refractory, 285 recurrent VF
- Participants
- 345 patients
- Comparison
- Double sequential external defibrillation (DSED) vs Standard
Methodological detailslogistic regression adjusted for Utstein variables, antiarrhythmics and epinephrine
- Logistic regression adjusted for Utstein variables, antiarrhythmics and epinephrine
Primary result
As reported in the abstract
Outcomes by defibrillation strategy and VF type
- DSED superior to standard for survival overall and for shock-refractory VF, but not for recurrent VF
- DSED superior to standard for return of spontaneous circulation (ROSC) and neurologic survival in shock-refractory and recurrent VF
- Vector change (VC) not superior for survival or ROSC overall, shock-refractory or recurrent VF, but superior for VF termination across all groups
- DSED vs Standard: P = 0.041
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Survival, recurrent vs shock-refractory VF | 2.76 (1.04–7.27) | |
| 0.10.31310Odds ratio (log scale) |
Original publication
The impact of alternate defibrillation strategies on shock-refractory and recurrent ventricular fibrillation: A secondary analysis of the DOSE VF cluster randomized controlled trial. Resuscitation. Published 24 March 2024. doi:10.
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