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Simultaneous Transthoracic Defibrillation With Two Defibrillators for Refractory Ventricular Fibrillation

A Literature Review

Wilson, Ellen E. BSN, RN

Advanced Emergency Nursing Journal: January/March 2015 - Volume 37 - Issue 1 - p 42–50
doi: 10.1097/TME.0000000000000051

Ventricular fibrillation and pulseless ventricular tachycardia are the presenting rhythm in half of sudden cardiac deaths and have a higher successful resuscitation rate than asystole and pulseless electrical activity. The goal of defibrillation is to stun the myocardium and allow normal cardiac pacemakers to take over. Current American Heart Association guidelines for the treatment of ventricular fibrillation may not recommend enough energy to terminate prolonged ventricular fibrillation. Several reports have looked at simultaneous cardioversion with two defibrillators for atrial fibrillation refractory to treatment guidelines and have a high success rate. Because atrial and ventricular fibrillation have many common features, it is reasonable to extrapolate that simultaneous defibrillation for ventricular fibrillation refractory to current guidelines may be beneficial in certain patient populations. The literature contains a few cases of simultaneous defibrillation with two defibrillators for refractory ventricular fibrillation; the technique should be considered for patients not responding to standard treatment.

University of Maryland School of Nursing, Baltimore.

Corresponding Author: Ellen E. Wilson, BSN, RN, University of Maryland School of Nursing, 655 West Lombard St, Baltimore, MD 21201 (;

The author thanks Bimbola F. Akintade, PhD, ACNP-BC, MBA, MHA and Kathryn T. VonRueden, RN, MS, ACNS-BC, FCCM for their assistance and support.

Disclosure: The author reports no conflicts of interest.

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