Case Reports on Successful Use of Two Defibrillators Sequentially for Refractory Ventricular Fibrillation

Double Sequence Defibrillation (DSD) is a proposed management strategy for refractory ventricular fibrillation that involves using two defibrillators rapidly in sequence at their maximum permitted energy level. Two sets of defibrillator pads are positioned: one in the anterior-lateral position and the other in the anterior-posterior position. The two defibrillation buttons are pushed one after the other in quick succession. Here we report two cases of in-hospital cardiac arrests due to refractory VF where Double Sequence Defibrillation was implemented. In the first case, a 23-year-old male presented with chest pain and had witnessed cardiac arrest, and after multiple defibrillation attempts including a double sequential defibrillation, he regained spontaneous circulation, ultimately leading to a full neurological recovery. The second case involved a 53-year-old male who, after experiencing a witnessed cardiac arrest, was successfully resuscitated using double sequential defibrillation after unsuccessful initial three single defibrillation attempts. These cases highlight the potential of double sequential defibrillation (DSD) as a promising intervention for patients with refractory VF, warranting further investigation into its role in improving outcomes.