Lee SGW, Park JH, Ro YS, et al. - Given the correlation of timely defibrillation with improved survival in out-of-hospital cardiac arrest (OHCA) cases, researchers here examined if the time to first defibrillation was linked with good neurological outcomes in OHCA patients with refractory ventricular fibrillation. They assessed 5,753 bystander-witnessed adult OHCA patients with presumed cardiac etiology who presented with ventricular fibrillation and received ≥ 2 successive prehospital defibrillations from emergency medical services between 2013 and 2018. Among these patients, overall rates of 34.4% for survival to discharge and 27.2% for good neurological recovery were reported. Outcomes suggest good neurological recovery in correlation with a short time from collapse to first defibrillation among patients with OHCA and refractory ventricular fibrillation, indicating that a failed first shock still has a positive effect if it is delivered quickly.