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DSED & VC Increase Survival for Refractory VF

Updated: Feb 9, 2023

Despite advances in defibrillation technology, shock-refractory Ventricular Fibrillation (VF) remains common.

What is Double Sequential External Defibrillation (DSED): Rapid sequential shocks from two defibrillators.

Vector-change (VC) defibrillation: Switching defibrillation pads to an anterior–posterior position.

Both DSED & VC are proposed strategies to improve outcomes in patients with refractory VF.

In a study conducted in Canada a total of 405 patients were enrolled to compare Standard Defibrillation (SD) vs DSED or VC. A total of 136 patients (33.6%) were assigned to receive SD, 144 (35.6%) to receive VC defibrillation, and 125 (30.9%) to receive DSED.

Survival to hospital discharge was more common in the DSED group than in the standard group (30.4% vs. 13.3%). In the VC group vs standard group (21.7% vs. 13.3%).

DSED but not VC defibrillation was associated with a higher percentage of patients having a good neurologic outcome vs standard defibrillation.


Among patients with refractory ventricular fibrillation, survival to hospital discharge occurred more frequently among those who received DSED or VC defibrillation than among those who received standard defibrillation.

(Funded by the Heart and Stroke Foundation of Canada)

Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.


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