• Dennis Miraglia, Lourdes A Miguel, and Wilfredo Alonso.
• Department of Internal Medicine, Good Samaritan Hospital, Aguadilla, PR, United States. Electronic address: dennismiraglia@hotmail.com.
• Am J Emerg Med. 2020 Mar 1; 38 (3): 648-654.

Study ObjectivesThe purpose of this review is to provide a brief overview of new life-saving interventions and novel techniques that have been proposed as viable treatment options for patients presenting with refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) out-of-hospital cardiac arrest (OHCA).MethodsWe conducted a comprehensive literature search of PubMed recent, Medline and Embase databases via the Ovid interface and Google Scholar from inception to July 2019. Eligible studies were observational in nature reporting outcomes of extracorporeal membrane oxygenation (ECMO), esmolol, double sequential defibrillation (DSD), and stellate ganglion block (SGB). Two investigators conducted the literature search, study selection, and data extraction. Any disagreements were resolved by consensus.ResultsOur database search identified 5331 records. We included in our review 23 articles that met our inclusion criteria. The selected studies included 16 observational studies on ECMO, 2 observational studies on esmolol, and 5 observational studies on DSD.ConclusionWe would like to suggest that there is not enough evidence in the existing literature to support at large-scale the effects of these techniques in the treatment of refractory VF/pVT OHCA. Randomized studies are warranted to evaluate the significant effects of these approaches against the best current standard of care.Copyright © 2019 Elsevier Inc. All rights reserved.

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