Early Double Sequential Defibrillation in Out of Hospital Cardiac Arrest

Summary

Some of the patients affected by Out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation (VF)/ventricular tachycardia (VT) do not respond to initial defibrillation. The survival decreases with number of defibrillations required to terminate VF/VT. In 2022, one prospective cluster randomized trial showed increased survival among (OHCA) patients in refractory VF using Double Sequential Defibrillation (DSD). If DSD can increase survival among all patients in VF that dont respond to one defibrillation, i.e. before it has become refractory is not known.

The aim of this trial is to assess survival with a double defibrillation strategy initiated as soon as possible among patients with Out of Hospital Cardiac Arrest with initial shockable rhythm and at least one failed standard defibrillation, compared with continued resuscitation using standard defibrillation.

Conditions

• Out of Hospital Cardiac Arrest
• Ventricular Fibrillation
• Defibrillation
• CPR
• ACLS
• Sudden Death

Interventions

DEVICE

Double sequential defibirllation

A second defibrillator will be applyed with electrodes placed in the A-P position and defibrillation will be performed with two defibrllators in a sequential manner

DEVICE

Standard defibrillation

Standard defibrillation uning one defibrillator

Sponsors & Collaborators

• Swedish Heart Lung Foundation

  collaborator OTHER

• Region Stockholm

  collaborator OTHER_GOV

• Vastra Gotaland Region

  collaborator OTHER_GOV

• Region Halland

  collaborator OTHER

• Laerdal Foundation

  collaborator OTHER

• Gabriel Riva

  lead OTHER

Principal Investigators

• Gabriel Riva, M.D. Ph.D. · Center for resuscitation Science. Department of clinical sience and education. Södersjukhuset, Karolinksa Institutet, Stockholm, Sweden

• Akil Awad, M.D. Ph.D. · Center for resuscitation Science. Department of clinical sience and education. Södersjukhuset, Karolinksa Institutet, Stockholm, Sweden

• Carl Magnusson, R.N., Ph.D. · Shalgrenska University Hospital

• Andreas Claesson, R.N. Ph.D. · Center for resuscitation Science. Department of clinical sience and education. Södersjukhuset, Karolinksa Institutet, Stockholm, Sweden

• Johan Israelsson, R.N. Ph.D. · ICARE, Department of Health and Caring Sciences, Linnaeus University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-08

Primary Completion

2028-12-31

Completion

2029-12-31

Countries

• Netherlands
• Spain
• Sweden

Study Locations