Wolf Creek XVIII Part 3: Innovations in Defibrillation Science

Introduction: Effective defibrillation lies at the heart of successful resuscitation of ventricular fibrillation cardiac arrest. Can it be done better? Methods: The 50th Anniversary Wolf Creek XVIII Conference was hosted by the Max Harry Weil Institute for Critical Care Research and Innovation in Ann Arbor, Michigan, USA on June 19-21, 2025. Since its inception in 1975, the Wolf Creek Conference has a well-established tradition of providing a unique forum for robust intellectual exchange between thought leaders and scientists from academia and industry focused on advancing the science and practice of cardiac arrest resuscitation. Results: Innovations in Defibrillation Science was one of six focused panel topics that was presented and discussed by invited panelist and conference participants as recognized thought leaders in the field of cardiac arrest resuscitation, all of whom completed conflict of interest disclosures.The presentations by invited panelist and discussion focused on four distinct defibrillation-related topics, each written as was presented by its contributing author, providing their individual perspectives. Where applicable, each discussion addressed the current state, potential future state, knowledge gaps, barriers to translation, and research priorities in defibrillation science. Topics included refining the definition of defibrillation and resuscitation success, describing defibrillation mechanisms, double sequential external defibrillation for refractory ventricular fibrillation, and use of quantitative waveform analysis to better direct resuscitation care. Conclusions: Although much is known, much remains to be learned about defibrillation and its optimal application during resuscitation of cardiac arrest.