# Refractory Ventricular Fibrillation Successfully Managed with Thrombolysis and Prolonged Resuscitation: A Case Report

## TL;DR

A 43-year-old man with refractory ventricular fibrillation was successfully treated using thrombolysis and extended resuscitation efforts.

## Contribution

This case report demonstrates successful management of refractory VF using thrombolysis and prolonged resuscitation.

## Key findings

- ROSC was achieved after 21 defibrillation shocks and thrombolysis.
- Severe in-stent restenosis was identified as the underlying cause.
- Multidisciplinary collaboration was crucial for a favorable outcome.

## Abstract

Refractory ventricular fibrillation (VF) is a critical condition that often presents with a poor prognosis and significant resuscitation challenges. We report the case of a 43-year-old man presenting with acute chest pain who sustained recurrent VF cardiac arrest in the emergency department. Due to prolonged resuscitation involving 21 defibrillation shocks, repeated advanced life support, and administration of thrombolysis, return of spontaneous circulation (ROSC) was achieved. Subsequent coronary angiography revealed severe in-stent restenosis in the left anterior descending artery, with successful percutaneous coronary intervention. This case highlights the importance of early recognition of refractory VF, the potential role of adjunctive therapies such as thrombolysis, and the value of multidisciplinary collaboration in achieving favourable outcomes.