Keep shocking: Double sequential defibrillation for refractory ventricular fibrillation.

Double sequential defibrillation is proposed as a novel modality of managing refractory ventricular fibrillation (VF). However, existing evidence has not been enough to support this. Here, we report an interesting case of a 54-year-old male who suffered from cardiac arrest with VF rhythm. The patient did not respond to 11 consecutive shocks along with antiarrhythmic medications. However, double sequential defibrillation terminated the VF. He had another episode of VF unresponsive to thirty minutes of standard defibrillation on his way to the catheterization laboratory. Again, the VF was terminated by double sequential defibrillation. Five days later, the patient was discharged home without neurological sequels.