Acute cardiac care & resuscitation

Incessant versus recurrent refractory ventricular fibrillation: classification and prognosis in out-of-hospital cardiac arrest

ResuscitationPublished retrospective cohort investigation

Authors' conclusion

Different methods classifying VF shock response produced excellent agreement. Recurrent-mixed-incessant shock responses were associated with progressive decline in favorable outcome, highlighting a measurable phenotype to direct care.

Study context

Population
Patients with ventricular fibrillation sudden cardiac arrest (VF-SCA) out of hospitalVF-SCA patients, 1018 (56%) had refractory VF-SCA
Participants
1,829 patients
Exposure
We compared two methods for recurrent versus incessant classification to understand their agreement and prognosis.
Outcome
Distribution of refractory VF-SCA subtypes

Main finding

As reported in the abstract

Observational data: associations, not effects.

Further findings

Favorable survival

Favorable survival — test-for-trend
p < 0.001

Agreement between classification methods (8-s snapshot for method 2)

Shock-specific kappa
0.97
Patient-level kappa
0.95
  • Agreement was greatest using the 8-s snapshot for method 2

Original publication

Incessant versus recurrent refractory ventricular fibrillation: classification and prognosis in out-of-hospital cardiac arrest. Resuscitation. Published 5 March 2026. doi:10.1016/j.resuscitation.2026.111039

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