Acute cardiac care & resuscitation
Refractory ventricular fibrillation in out-of-hospital cardiac arrest: shock characteristics, predictors and clinical outcomes
Main finding · Return of spontaneous circulation (ROSC)Result — go to the resultRelative risk 0.69 95% CI 0.41–1.15Authors' conclusion
The small group of refractory VF patients were characterised by unfavourable resuscitation characteristics. Clinical outcomes in refractory VF versus recurrent VF patients remain uncertain due to low patient numbers.
Study context
- Population
- Patients with out-of-hospital cardiac arrest with ventricular fibrillation (VF) at the first three rhythm checkspatients who met the inclusion criteria
- Participants
- 436 patients
- Exposure
- Outcomes and possible predictors between both groups were compared
- Refractory VFn = 22
- Recurrent VFn = 414reference
- Outcome
- Return of spontaneous circulation (ROSC)
Methodological detailsARREST registry, 2016 and 2019
- ARREST registry
- 2016 and 2019
Main finding
As reported in the abstract
Relative risk
0.69
95% CI 0.41–1.15
Events by group
Refractory VFvs recurrent VF
RR 0.69 (95% CI 0.41–1.15)
Observational data: associations, not effects.
Further findings
| Outcome | Refractory VF | Recurrent VF | RR (95% CI) | |
|---|---|---|---|---|
| 30-day survival | 23% | 46% | 0.49 (0.23–1.08) | |
| 0.20.5125Relative risk (log scale) |
Predictors for refractory VF
- Absence of CPR and AED use before emergency medical services arrival
- A longer delay to the first shock
- A lower amplitude spectral area value
Original publication
Refractory ventricular fibrillation in out-of-hospital cardiac arrest: shock characteristics, predictors and clinical outcomes. Resuscitation. Published 8 June 2026. doi:10.
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