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March 12, 2008

Progress in Resuscitation: An Evolution, Not a Revolution

Author Affiliations

Author Affiliations: Departments of Internal Medicine (Cardiology) (Dr Peberdy) and Emergency Medicine (Dr Ornato), Virginia Commonwealth University, Richmond.

JAMA. 2008;299(10):1188-1190. doi:10.1001/jama.299.10.1188

There was a time not long ago when the quality and quantity of chest compressions did not seem that important during resuscitation—at least not in comparison with early defibrillation. A ventricular tachyarrhythmia is the initiating event in more than 80% of patients who develop out-of-hospital, primary cardiac arrest during ambulatory electrocardiographic monitoring.1 Survival declines rapidly if defibrillation is not performed in the first few minutes (defibrillation phase) because myocardial adenosine triphosphate (ATP) levels begin to decrease as fibrillating myocardial cells continue to consume ATP at a nearly normal rate.2,3