Vancouver tied it twice when trailing by two goals, the last with two goals about 50 seconds apart in the final 1:06 of regulation. Conor Garland made it a one-goal game, and Andrei Kuzmenko tied it with his second goal of the night with 15.4 seconds left.
Duchene beat goalie Collin Delia as Nashville's second shooter, and he improved to 4 of 5 in shootouts this season. Goalie Juuse Saros stopped Kuzmenko, J.T. Miller and Elias Petterson for the win.
''When you get to four, you've got to be able to close out the game,'' Nashville coach John Hynes said. ''They had some breaks. They did a good job, too. I think on the six-on-five, we had multiple shot blocks, couldn't get the clear on it. Guys were exhausted. They wound up making a good play.''
Cole Smith, Philip Tomasino, Nino Niederreiter and Mikael Granlund each had a goal for Nashville, winners of two of its last three. The Predators also took the season series at 2-0 - both in shootouts - with one game left in Vancouver on March 6.
''There's a lot of areas we got to be better,'' Niederreiter said. ''But we found a way to win the game, which is all that matters right now.''
Quinn Hughes had two assists, and Sheldon Dries also had a goal for Vancouver, which has lost four of five. Pettersson had an assist in his 300th career game.
Miller said he thought the Canucks outplayed Nashville much of the game.
''Once you get past the end of regulation, it's kind of a crapshoot from that point,'' Miller said.
Smith put Nashville up 1-0 at 4:38 of the first period, tapping the puck in from the side of the net. Tomasino made it 2-0 on the power play at 7:57 of the second with his first goal since being called up to replace Filip Forsberg, out with an upper-body injury since Feb. 11.
Kuzmenko beat Saros over his glove at 12:47 of the second on the breakaway off a turnover by Nashville defenseman Mattias Ekholm for his third straight game with a goal. Kuzmenko extended his points streak to four games.
Vancouver tied it at 2 when Dries tapped in a puck Saros thought he had stopped before the net came off the pegs with 22 seconds left in the second. Nashville retook the lead 12 seconds later as Niederreiter got his 16th on a backhander past Delia.
Granlund provided what appeared to be the game-winner with a backhander at the left side of the net at 7:44 of the third before Vancouver's final push.
Predators center Ryan Johansen was helped to the locker room late in the second after Hughes' skate appeared to clip the back of his right leg. Johansen left the arena on crutches with his right foot in a boot, putting no weight on that leg.
''It didn't look good,'' Hynes said. ''I know that he got cut.''
The Canucks made defenseman Luke Schenn a healthy scratch, sending him back to Vancouver in advance of the March 3 trade deadline.
''It's the world we live in right now, in that trade deadline world,'' Canucks coach Rick Tocchet said. ''I talked to Luke today. Guy's a great pro. I was talking to J.T. about this, around the trade deadline, a lot of weird things happen. Other teams are going through the same thing.''
HALL OF FAME SURPRISE
Former Nashville captain Mike Fisher was surprised during the first intermission with the announcement he will be inducted into the Tennessee Sports Hall of Fame in July. He retired after the 2017 run to the Stanley Cup Final before coming back in January 2018 as Nashville won its first Presidents' Trophy.
Canucks: At St. Louis on Thursday night.
Predators: At San Jose on Thursday night.
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