Acute cardiac care & resuscitation

The impact of defibrillation current and pad position on return of spontaneous circulation during refractory ventricular fibrillation

ResuscitationPublished secondary, per-protocol analysis

Authors' conclusion

AP delivered higher current than AL positioning; however, pad position rather than delivered current was independently associated with ROSC. These findings suggest the additional AP pad position may be a key mechanistic contributor to the benefit of VC and DSED.

Study context

Population
Patients with refractory ventricular fibrillation enrolled in the Double Sequential External Defibrillation for Refractory VF (DOSE VF) trialpatients included, contributing 849 interventional shocks
Participants
342 patients
Comparison
Current delivery was compared across standard anterolateral (AL), vector-change (VC) anteroposterior (AP), and double sequential external defibrillation (DSED; AL + AP) shocks

Primary result

As reported in the abstract

Interventional shocks by type
Interventional shocks
849

Further findings

OutcomeaOR (95% CI)
ROSCAP positioningvs AL positioningGEE modeling2.01 (1.12–3.59)

Mean current

VC AP shocks
19.6 A
DSED AP shocks
19.2 A
Standard AL shocks
16.6 A
DSED AL shocks
17.3 A
  • Mean current significantly greater for AP shocks (P < 0.001)

Return of spontaneous circulation (ROSC)

Delivered current was not associated with ROSC

Original publication

The impact of defibrillation current and pad position on return of spontaneous circulation during refractory ventricular fibrillation. Resuscitation. Published 17 March 2026. doi:10.1016/j.resuscitation.2026.111061

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.