The impact of defibrillation current and pad position on return of spontaneous circulation during refractory ventricular fibrillation

The authors aimed to investigate how pad position and transthoracic current delivery affect the return of spontaneous circulation (ROSC) in patients experiencing refractory ventricular fibrillation during defibrillation. Their analysis revealed that while the anteroposterior (AP) pad position delivered higher current than the standard anterolateral (AL) position, it was the pad position itself, rather than the amount of current delivered, that was independently associated with improved ROSC outcomes. This suggests that the AP positioning may enhance the efficacy of defibrillation techniques like vector-change and double sequential external defibrillation.