Refractory Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest: Shock Characteristics, Predictors and Clinical Outcomes

The authors aimed to investigate the incidence, predictors, and clinical outcomes of refractory versus recurrent ventricular fibrillation (VF) in patients experiencing out-of-hospital cardiac arrest (OHCA). They found that only 5% of patients had refractory VF, which was associated with poorer resuscitation characteristics and uncertain clinical outcomes compared to those with recurrent VF. Key predictors for refractory VF included the absence of CPR and AED use prior to EMS arrival, longer delays to the first shock, and lower amplitude spectral area values.