Reconfirmation algorithms should be the standard of care in automated external defibrillators.

Abstract

Non-sustained and self-terminating arrhythmias pose a significant challenge during resuscitation. Delivery of a defibrillation shock to a non-shockable rhythm has a poorly understood effect on the heart. The importance of assessing rhythm right up until the delivery of a shock is of increased importance when "blind" shocks are being delivered by automatic defibrillators or minimally trained rescuers. Reconfirmation algorithms are common in current-generation implantable defibrillators but this investigation of current-generation AEDs shows that only 71% of devices presently available have reconfirmation algorithms. A case of spontaneous reversion of a non-sustained arrhythmia is presented. The implications of delivering a defibrillator shock to a non-shockable rhythm are discussed.