# Refractory Ventricular Fibrillation in the Context of ST-Elevation Myocardial Infarction (STEMI): A Case Report of Survival With Double Sequential External Defibrillation and Percutaneous Coronary Intervention

## TL;DR

A 42-year-old man survived a life-threatening heart rhythm using a special defibrillation technique and timely heart treatment.

## Contribution

Demonstrates successful use of double sequential external defibrillation for refractory ventricular fibrillation during a heart attack.

## Key findings

- DSED with lateral decubitus position restored circulation after multiple conventional defibrillation failures.
- Thrombolysis and coronary revascularization led to full neurological and cardiac recovery.
- Timely intervention and post-resuscitation care were critical for positive outcomes.

## Abstract

Refractory ventricular fibrillation (RVF) is a life-threatening arrhythmia that remains a challenge despite adherence to advanced resuscitation protocols. We present the case of a previously healthy 42-year-old man who experienced in-hospital cardiac arrest due to RVF following an acute inferolateral myocardial infarction. After multiple unsuccessful conventional defibrillation attempts, double sequential external defibrillation (DSED) with lateral decubitus position was employed as a salvage maneuver, resulting in return of spontaneous circulation (ROSC). The patient subsequently underwent successful thrombolysis and coronary revascularization with complete neurological and cardiac recovery. This case exemplifies the potential utility of DSED in treating RVF and emphasizes the importance of timely recognition, intervention, and post-resuscitation care in improving outcomes.