Refractory ventricular fibrillation is not an uncommon cardiac arrhythmia that is observed in patients with cardiac arrest. In this case, a 49-year-old male presented to the Emergency Department with an anterior ST-elevation myocardial infarction (STEMI). It began as a witnessed cardiac arrest with multiple rounds of unsuccessful standard defibrillation. The typical duration of CPR is approximately 20 minutes; however, with his O2 saturation at 98%, dual-sequential defibrillation (DSD) commenced, and after 52 minutes return of spontaneous circulation (ROSC) was obtained. Prior to this event, the longest ROSC recorded with a favorable outcome was 47 minutes. Currently, the ALCS is the gold standard for treatment during various cardiopulmonary emergencies, yet there is no guidance on refractory ventricular fibrillation. In these cases, multiple factors should be considered when determining whether or not to continue CPR. DSD is a promising treatment strategy to obtain ROSC, when the advanced cardiovascular life support (ALCS) protocol has been exhausted, and the O2 saturation levels have been maintained.