Acute cardiac care & resuscitationCohort study
Refractory ventricular fibrillation in out-of-hospital cardiac arrest: shock characteristics, predictors and clinical outcomes
- registry study
- ARREST registry
- 2016 and 2019
Authors' 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
Main finding
Return of spontaneous circulation (ROSC)
Relative risk
0.69
95% CI 0.41–1.15
Events by group
refractory VF vs recurrent VF
RR 0.69 (95% CI 0.41–1.15)
As reported in the abstract
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:10.1016/j.resuscitation.2026.111166
Summarised from the published abstract; every number is checked against it