Testing New Defibrillation Techniques in Out-of-Hospital Cardiac Arrest

Up to half of people who experience out-of-hospital cardiac arrest related to ventricular fibrillation (VF) remain in VF after three defibrillation shocks. To assess what defibrillation strategy to use subsequently, researchers in Canada conducted a cluster-randomized trial (NCT04080986) that assigned 405 patients with out-of-hospital VF who had failed three sequential shocks with pads in the standard anterior–lateral positions to one of three approaches:

• Standard defibrillation: continuation of shocks using the standard anterior–lateral pad positions

• Vector-change defibrillation: a switch in pad orientation to anterior–posterior

• Double sequential external defibrillation: adding anterior–posterior pads, paired with a second defibrillator, allo…