External Defibrillator Damage Associated With Attempted Synchronized Dual-Dose Cardioversion

Ann Emerg Med. 2018 Jan;71(1):109-112. doi: 10.1016/j.annemergmed.2017.04.005. Epub 2017 May 27.


The simultaneous use of 2 external defibrillators to administer either dual or sequential cardioversion or defibrillation for refractory cardiac arrhythmias is increasing in both the out-of-hospital and inhospital settings. Using 2 defibrillators to administer higher energy levels than can be achieved with a single defibrillator is considered off-label and is currently not part of published advanced cardiac life support guidelines. We report the first case in which the use of dual-dose cardioversion was associated with external defibrillator damage. Because defibrillator damage, especially if undetected, jeopardizes patient safety and off-label medical product use may void the manufacturer's warranty, this case should urge users to proceed with caution when contemplating this technique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Defibrillators*
  • Electric Countershock / instrumentation*
  • Electric Countershock / methods
  • Equipment Failure*
  • Humans
  • Male
  • Tachycardia, Ventricular / therapy*