As an important medical electronic equipment for the cardioversion of malignant arrhythmia such as ventricular fibrillation and ventricular tachycardia, cardiac external defibrillators have been widely used in the clinics. However, the resuscitation success rate for these patients is still unsatisfied. In this paper, the recent advances of cardiac external defibrillation technologies is reviewed. The potential mechanism of defibrillation, the development of novel defibrillation waveform, the factors that may affect defibrillation outcome, the interaction between defibrillation waveform and ventricular fibrillation waveform, and the individualized patient-specific external defibrillation protocol are analyzed and summarized. We hope that this review can provide helpful reference for the optimization of external defibrillator design and the individualization of clinical application.
The American Heart Association published the “2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care” in the journal Circulation in October 2025. The new guideline integrates the previously separate adult survival chains for different scenarios and populations into a unified “six-link survival chain” and provides updates and recommendations for multiple key components. Key updates emphasize the following contents: in basic life support, optimization of rescuers’ and patients’ positions, compression strategies for obese or prone patients, systematic management procedures for foreign-body airway obstruction, and details of automated external defibrillator application; in advanced life support, strengthening the core role of epinephrine and standardizing the use of vasoactive agents; updated resuscitation strategies for special situations (such as exposure to highly pathogenic respiratory pathogens and volatile hydrocarbon poisoning); in post-cardiac arrest care, further updates to respiratory and circulatory support, targeted temperature management, and neurological prognosis assessment; and recommendations at the system of care level, including public access to naloxone, video-based dispatch response, and the establishment of resuscitation centers. This article interprets the core recommendations of the guideline to offer references for clinical practice and education.