Acute cardiac care & resuscitationSecondary analysis
The impact of defibrillation current and pad position on return of spontaneous circulation during refractory ventricular fibrillation
- 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
| Outcome | aOR (95% CI) | |
|---|---|---|
| ROSC · GEE modeling | 2.01 (1.12–3.59) | |
| 0.20.5125Adjusted odds ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it