Alternative defibrillation strategies: More answers and more questions

Approximately one-quarter of out-of-hospital cardiac arrests (OHCA) treated by emergency medical services (EMS) have an initial ventricular fibrillation (VF) or pulseless ventricular tachycardia.1–3 While these patients have better outcomes compared to patients with non-shockable rhythms, about half do not respond to multiple defibrillation attempts and remains in VF, decreasing their likelihood of successful resuscitation and favourable outcomes.4–6