Date of Award

Spring 2026

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Jay Metzger

Second Advisor

Kristen Carr

Abstract

Each year in the United States, an estimated 300,000 people experience out of hospital cardiac arrest (OHCA) and approximately 92% of people experiencing a OHCA event die. OHCA survivability has been linked to termination of lethal cardiac arrythmias, among other factors. Refractory ventricular fibrillation (rVF) and recurrent ventricular tachycardia (rVT) which are defined as lethal cardiac arrythmias characterized by persistence despite multiple defibrillation attempts. Although several therapies have been proposed to terminate these arrythmias, there is no widely recognized guidelines for treatment of rVF/rVT. This literature review evaluates the effectiveness of dual sequential defibrillation (DSD), a proposed treatment strategy for refractory shockable arrhythmias, as compared to conventional defibrillation in reducing mortality. A comprehensive search of PubMed and Embase from June 2025 through September 2025 identified 451 studies, with six studies meeting criteria for final analysis. DSD did not significantly improve mortality when analyzed in retrospective studies, however, conflicting results exist from a randomized control study in which DSD did statistically lower mortality. These findings underline the need for continued adherence to established OHCA protocol in practice and future large, multi-center randomized controlled studies to determine if there is true efficacy in reducing mortality.

Comments

Note: this is a corrected draft of the student work, not the final version

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