The annual incidence of sudden cardiac deaths in the United States is about 300,000 cases. Ventricular fibrillation (VF) remains an important cause of sudden death both in hospitals and in the community contributing to about half of these cases, although in monitored setting with rapid response times, VF is the presenting rhythm in almost three quarters of these patients. Despite an overall declining trend in the incidence of VF, the management of the arrhythmia remains challenging due to the fact that the event is usually unexpected and almost certainly lethal in the absence of resuscitation within the first few minutes. There has been a dramatic improvement in survival from VF due to the introduction of defibrillation as a part of resuscitation but in a significant proportion of patients, the process of resuscitation proves futile due to lack of return of spontaneous circulation or significant neurological disability caused by cerebral anoxia.