Actively Recruiting
A Randomized Trial Assessing Early Double Sequential Defibrillation Compared to Standard Defibrillation in Out-of-Hospital Cardiac Arrest with Shockable Rhythm and Failed Initial Defibrillation
Led by Gabriel Riva · Updated on 2026-02-17
916
Participants Needed
14
Research Sites
47 weeks
Total Duration
On this page
Sponsors
G
Gabriel Riva
Lead Sponsor
S
Swedish Heart Lung Foundation
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are studying patients who experience out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation (VF) or ventricular tachycardia (VT) that do not respond to initial defibrillation. The study aims to evaluate whether using double sequential defibrillation (DSD) earlier, after the first failed standard defibrillation, can improve 30-day survival compared to continuing with standard defibrillation. This trial addresses important gaps in knowledge about optimal defibrillation strategies to increase survival in this critical condition. The trial compares two treatment groups: one using early double sequential defibrillation, where a second defibrillator with pads placed in the anterior-posterior position is applied as soon as possible, delivering rapid sequential shocks from two devices; and the other continuing with standard single defibrillation using one defibrillator with anterior-lateral pad placement. Both groups receive resuscitation until return of spontaneous circulation, resuscitation is stopped, or the patient is transported to the hospital. The study is randomized and open-label, involving ambulance units equipped with two study-specific defibrillators. Participants are adult OHCA patients with an initial shockable rhythm and at least one failed standard defibrillation. During the study, ambulance teams perform screening, randomization, treatment according to assigned group, and initial follow-up. The main outcome measured is survival at 30 days. Secondary outcomes include return of spontaneous circulation, survival to hospital admission and discharge, and neurological function at discharge. The study will continue monitoring these outcomes to assess the effectiveness of early DSD compared to standard defibrillation strategies.
CONDITIONS
Brief Title
Early Double Sequential Defibrillation in Out of Hospital Cardiac Arrest
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Adult patients with out-of-hospital cardiac arrest showing ventricular tachycardia or ventricular fibrillation at first rhythm check
- At least one defibrillation performed using standard anterior-lateral pad placement without return of spontaneous circulation
You will not qualify if you...
- Age under 18 years
- Obvious pregnancy
- Known Do Not Attempt Resuscitation order
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Screening and enrollment occur at the time of cardiac arrest by EMS units with study-specific defibrillators available on site.
Duration - Until return of spontaneous circulation, termination of resuscitation, or decision to move the patient to hospital
Participants receive either early double sequential defibrillation using two defibrillators applied in rapid sequence or standard defibrillation with one defibrillator during out-of-hospital cardiac arrest until return of spontaneous circulation, termination of resuscitation, or transport to hospital.
Treatment occurs during emergency care provided by ambulance crews on site; no additional scheduled visits
Duration - 30 days
Participants are followed for survival and neurological outcomes up to 30 days after the cardiac arrest.
Assessments occur up to 30 days post-event; specific visit schedule depends on hospital care and follow-up procedures
Trial Site Locations
Total: 14 locations
1
ARREST (AmsteRdam REsuscitation STudies)
Amsterdam, Netherlands
Not Yet Recruiting
2
Centro de Emergencias 061 Andalucía
Málaga, Andalusia, Spain, 29560
Not Yet Recruiting
3
Médico Emergencias Osakidetza EMERGENTZIAK
Bilbao, Baque Country, Spain, 48004
Not Yet Recruiting
4
Sistema de Emergencias Medicas de Catalunya
Barcelona, Catalonia, Spain, 08908
Not Yet Recruiting
5
SUMMA 112 Emergency medical services
Madrid, Madrid, Spain, 28045
Not Yet Recruiting
6
Ambulanssjukvården, Region Halland
Halmstad, Halland County, Sweden
Actively Recruiting
7
Ambulanssjukvården Region Värmland
Karlstad, Värmland County, Sweden, 65230
Actively Recruiting
8
Ambulanshelikoptern (HEMS) Västra Götalandsregionen
Kungälv, Västra Götaland County, Sweden, 442 83
Actively Recruiting
9
Sjukvården i väster
Alingsås, Sweden
Actively Recruiting
10
Emergency medical services, Södra Älvsborgs Sjukhus, Region Västra Götaland
Borås, Sweden, 501 82
Actively Recruiting
11
Prehospital Intensive Care Unit (PIV) AnOPIVA Östra Sjukhuset/SU
Gothenburg, Sweden
Actively Recruiting
12
Shalgrenska University Hospital
Gothenburg, Sweden
Actively Recruiting
13
Ambulanssjukvården Skaraborgs Sjukhus, Västra Götalandsregionen (SKAS)
Skövde, Sweden
Actively Recruiting
14
Emergency medical services NU-Sjukvården, Region Västra Götaland
Trollhättan, Sweden, 461 85
Actively Recruiting
Research Team
G
Gabriel Riva, M.D. Ph.D
A
Akil Awad, M.D. Ph.D.
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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