Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade

Introduction: The mortality rate for refractory ventricular fibrillation (RVF) can be up to 97%. There is no widely accepted treatment plan for this stage of ventricular fibrillation besides the standard combination of defibrillation, amiodarone, and epinephrine. One novel approach that has been doc...

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Main Authors: Humza Khan, Jennifer Campoli, Susan Wojcik
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2025-04-01
Series:Clinical Practice and Cases in Emergency Medicine
Online Access:https://escholarship.org/uc/item/11w9m6h7
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author Humza Khan
Jennifer Campoli
Susan Wojcik
author_facet Humza Khan
Jennifer Campoli
Susan Wojcik
author_sort Humza Khan
collection DOAJ
description Introduction: The mortality rate for refractory ventricular fibrillation (RVF) can be up to 97%. There is no widely accepted treatment plan for this stage of ventricular fibrillation besides the standard combination of defibrillation, amiodarone, and epinephrine. One novel approach that has been documented in a select few cases since 2015 is the combination of double external defibrillation (DED) and esmolol-induced beta blockade. Case Report: We report the case of a 65-year-old man who presented with RVF after collapsing at work. Upon the simultaneous administration of two defibrillators with a combined shock of 400 joules and 35 milligrams of the beta blocker esmolol, the patient regained pulse and began blinking. He was discharged from the hospital after seven days and walked out of the clinic. Conclusion: This case continues the trend of several case reports since 2015 that have featured beta blockade and double external defibrillation as a viable solution to refractory ventricular fibrillation. Since there is limited quantifiable data on the efficacy of this treatment, future studies should aim to evaluate whether the combination of DED and beta blockade has the potential to become the new standard in treating RVF over a broader patient population.
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spelling doaj-art-84ad6ee83f7e4a398f2e893f6d06dbea2025-08-20T03:47:32ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-04-019220020210.5811/cpcem.3861cpcem-9-200Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta BlockadeHumza Khan0Jennifer Campoli1Susan Wojcik2Upstate Medical University, Department of Emergency Medicine, Syracuse, New YorkUpstate Medical University, Department of Emergency Medicine, Syracuse, New YorkUpstate Medical University, Department of Emergency Medicine, Syracuse, New YorkIntroduction: The mortality rate for refractory ventricular fibrillation (RVF) can be up to 97%. There is no widely accepted treatment plan for this stage of ventricular fibrillation besides the standard combination of defibrillation, amiodarone, and epinephrine. One novel approach that has been documented in a select few cases since 2015 is the combination of double external defibrillation (DED) and esmolol-induced beta blockade. Case Report: We report the case of a 65-year-old man who presented with RVF after collapsing at work. Upon the simultaneous administration of two defibrillators with a combined shock of 400 joules and 35 milligrams of the beta blocker esmolol, the patient regained pulse and began blinking. He was discharged from the hospital after seven days and walked out of the clinic. Conclusion: This case continues the trend of several case reports since 2015 that have featured beta blockade and double external defibrillation as a viable solution to refractory ventricular fibrillation. Since there is limited quantifiable data on the efficacy of this treatment, future studies should aim to evaluate whether the combination of DED and beta blockade has the potential to become the new standard in treating RVF over a broader patient population.https://escholarship.org/uc/item/11w9m6h7
spellingShingle Humza Khan
Jennifer Campoli
Susan Wojcik
Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
Clinical Practice and Cases in Emergency Medicine
title Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
title_full Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
title_fullStr Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
title_full_unstemmed Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
title_short Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade
title_sort case report refractory ventricular fibrillation resolved by double external defibrillation and beta blockade
url https://escholarship.org/uc/item/11w9m6h7
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AT susanwojcik casereportrefractoryventricularfibrillationresolvedbydoubleexternaldefibrillationandbetablockade