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First Report of Survival in Refractory Ventricular Fibrillation After Dual-Axis Defibrillation and Esmolol Administration

Abstract

Ventricular fibrillation (VF) is a potentially fatal dysrhythmia associated with acute myocardial infarction. The longer a patient waits for definitive care, the greater their chance of mortality.  There is a subset of patients, however, who suffered a VF arrest, received appropriate care, and despite standard medications (epinephrine and amiodarone) and multiple defibrillations (3+ attempts at 200 J of biphasic current), remained in refractory VF (RVF), also known as electrical storm.  The mortality for these patients is as high as 97%. We present the case of a patient who, because of a novel approach, survived RVF to discharge and outpatient follow-up.

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