Refractory Ventricular Fibrillation Successfully Managed with Thrombolysis and Prolonged Resuscitation: A Case Report

Refractory ventricular fibrillation (VF) is a critical condition that often presents with a poor prognosis and significant resuscitation challenges. We report the case of a 43-year-old man presenting with acute chest pain who sustained recurrent VF cardiac arrest in the emergency department. Due to prolonged resuscitation involving 21 defibrillation shocks, repeated advanced life support, and administration of thrombolysis, return of spontaneous circulation (ROSC) was achieved. Subsequent coronary angiography revealed severe in-stent restenosis in the left anterior descending artery, with successful percutaneous coronary intervention. This case highlights the importance of early recognition of refractory VF, the potential role of adjunctive therapies such as thrombolysis, and the value of multidisciplinary collaboration in achieving favourable outcomes.