Double Sequence Defibrillation in an Out-of-Hospital Cardiac Arrest Patient with Refractory Ventricular Fibrillation: A Case Report

雙重連續性電擊院外心臟驟停頑固型心室顫動除顫成功：病例報告

阮昱中(Yu-Chung Juan)；阮祺文(Chi-Wen Juan)

Ventricular fibrillation ； Refractory ventricular fibrillation ； Double sequential defibrillation ； 心室顫動 ； 頑固型心室顫動 ； 雙重連續性電擊

醫學與健康期刊

9卷1期（2020 / 03 / 01）

109 - 117

英文

In the setting of cardiac arrest, ventricular fibrillation and pulseless ventricular tachycardia and considered, shock-treatable rhythms. They have a higher resuscitation rate than either asystole or pulseless electrical activity. However, there are occasions when ventricular fibrillation does not respond to standard defibrillator shocks. Herein, we present a case of successful termination of refractory ventricular fibrillation by double sequence defibrillation. The case later received percutaneous coronary intervention. He was discharged with neurological performance intact.

在到院前心肺功能停止病患的心率中，無脈性心室頻脈與心室顫動這兩種心率對於去顫電擊的反應成功率比心搏停止和無脈性電氣活動心率是相對較高的。然而有少數頑固型心室顫動的病患對於一般多次標準去顫的治療是無效的。目前已有越來越多的成功個案報告顯示出雙重連續性的去顫電擊對於此類病患有較高的去顫機率。本頑固型心室顫動個案藉由雙重連續性電擊成功去顫後，完成心導管重新灌流介入治療，順利出院且無留下神經學上的後遺症。

1. Bell, CR,Szulewski, A,Brooks, SC(2018).Make it two: A case report of dual sequential external defibrillation.CJEM,20,792-797.
2. Berdowski, J,Berg, RA,Tijssen, JGP(2010).Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.Resuscitation,81,1479-1489.
3. Delorenzo, A,Nehme, Z,Yates, J,Bemard, S,Smith, K(2019).Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis.Resuscitation,135,124-129.
4. Gerstein, N,Shah, M,Jorgensen, K(2015).Simultaneous use of two defibrillators for the conversion of refractory ventricular fibrillation.J Cardiothorac Vasc Anesth,29,421-424.
5. Gerstein, NS,McLean, AR,Stecker, EC,Schulman, PM(2018).External defibrillator damage associated with attempted synchronized dual-dose cardioversion.Ann Emerg Med,71,109-112.
6. Hajjar, K,Berbari, I,El Tawil, C,Bou, Chebl, R,Abou Dagher, G(2018).Dual defibrillation in patients with refractory ventricular fibrillation.Am J Emerg Med,36,1474-1479.
7. Hoch, DH,Batsford, WP,Greenberg, SM(1994).Double sequential external shocks for refractory ventricular fibrillation.J Am Coll Cardiol,23,1141-1145.
8. Leacock, BW(2014).Double simultaneous defibrillators for refractory ventricular fibrillation.J Emerg Med,46,472-474.
9. Lybeck, A,Moy, H,Tan, D(2015).Double sequential defibrillation for refractory ventricular fibrillation: a case report.Prehosp Emerg Care,19,554-557.
10. Sakai, T,Iwami, T,Tasaki, O(2010).Incidence and outcomes of out-of-hospital cardiac arrest with shock-resistant ventricular fibrillation: data from a large population-based cohort.Resuscitation,81,956-961.
11. Zabel, A,Bence, JR,Couperus, K(2018).Double Sequence Defibrillation for Out-of-hospital Cardiac Arrest: Unlikely Survival.Clin Pract Cases Emerg Med,2,1-3.
12. Zhang, Y,Clark, CB,Davies, LR,Karlsson, G,Zimmerman, MB,Kerber, R(2002).Body weight is a predictor of biphasic shock success for low energy transthoracic defibrillation.Resuscitation,54,281-287.