Ventricular Fibrillation Unresponsive to Standard Defibrillation Followed by Unassisted Return of Spontaneous Circulation: The Lazarus Phenomenon

The Lazarus phenomenon or the unassisted return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR) continues to be a mystery and so far there is no scientific explanation of the exact mechanism of autoresuscitation. The occurrence of this phenomenon is probably widely underreported and have been described in the medical literature at least 40 times since 1982. This paper presents an unique case of an 68-year-old man with third-degree atrioventricular (AV) block and an implanted cardiac pacemaker with refractory ventricular fibrillation (RVF) unresponsive to standard defibrillation (SD) followed by delayed or unassisted ROSC after cessation of CPR with an irregular idioventricular rhythm, as well as intermittent ventricular non-capture pacemaker stimuli. We decided to share this case via publication because this phenomenon is not well understood and there are likely many cases of unassisted ROSC after cessation of CPR that are no reported