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In cardiac arrest, if the initial rhythm is ventricular fibrillation (VF) or pulseless ventriculartachycardia, the survival rates are high and good neurologic outcomes are expected. However,the mortality rate increases when refractory ventricular fibrillation (RVF) occurs. We report acase of RVF that was successfully resuscitated with double sequence defibrillation (DSD). A51-year-old man visited the emergency department with chest pain. The initial electrocardiographyshowed markedly elevated ST-segment on V1–V5 leads, and VF arrest occurred. Although10 defibrillations were administered over 20 minutes, there was no response. Tworounds of DSD were performed by placing additional pads on the patient’s anterior-posteriorareas and sequentially applying the maximum energy setting. The patient returned to spontaneouscirculation and was discharged with cerebral performance category 1 after 14 days ofhospital admission. Therefore, DSD could be an option for treatment and termination of RVF.
