Cardiac arrest & resuscitation
Refractory ventricular fibrillation in out-of-hospital cardiac arrest: shock characteristics, predictors and clinical outcomes
Authors' conclusion
The small group of refractory VF patients were characterised by unfavourable resuscitation characteristics. Clinical outcomes in refractory VF versus recurrent VF patients remain uncertain due to low patient numbers.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation (VF) at the first three rhythm checks, ARREST registry, 2016–2019
- Participants
- 436 patients
- Exposure
- Refractory VF vs recurrent VF
- Refractory VFn = 22
- Recurrent VFn = 414reference
- Outcome
- Incidence of refractory VF
Methodological detailsARREST registry, ECG waveform analysis
- ARREST registry
- ECG waveform analysis
Main finding
As reported in the abstract
Incidence of refractory vs recurrent VF
Observational data: associations, not effects.
Further findings
| Outcome | Refractory VF | Recurrent VF | Estimate | |
|---|---|---|---|---|
| ROSC | 41% | 59% | RR for ROSC 0.69 (95% CI 0.41–1.15) | |
| 30-day survival | 23% | 46% | RR for 30-day survival 0.49 (95% CI 0.23–1.08) | |
| 0.20.5125Ratio (log scale) |
- ROSC: denominators 9/22 vs 243/409
- 30-day survival: denominators 5/22 vs 187/408
Original publication
Refractory ventricular fibrillation in out-of-hospital cardiac arrest: shock characteristics, predictors and clinical outcomes. Resuscitation. Published 8 June 2026. doi:10.
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