First Report of Survival in Refractory Ventricular Fibrillation After Dual-Axis De brillation and Esmolol Administration

Ventricular fibrillation (VF) is a potentially fatal dysrhythmia associated with acute myocardial infarction. The longer a patient waits for definitive care, the greater their chance of mortality. There is a subset of patients, however, who suffered a VF arrest, received appropriate care, and despite standard medications (epinephrine and amiodarone) and multiple defibrillations (3+ attempts at 200 J of biphasic current), remained in refractory VF (RVF), also known as electrical storm. The mortality for these patients is as high as 97%. We present the case of a patient who, because of a novel approach, survived RVF to discharge and outpatient follow-up.