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December 16, 1974

Fringe Benefits of Myocardial Infarction

JAMA. 1974;230(11):1565. doi:10.1001/jama.1974.03240110057022

It has been known for many years that recurrent angina sometimes disappears after an attack of myocardial infarction. Unlike the ischemic, the dead myocardium generates no pain. Can an analogous benefit be expected in a patient with recurrent ventricular fibrillation? May not myocardial infarction kill the irritable, unstable ischemic tissue, thus preventing it from generating abnormal, potentially lethal dysrhythmias?

In an editorial with the arresting title, "Di Si Dolce Morte: It May Be Safer to Be Dead Than Alive," Warren1 suggests that this may well be the case. In support of this view, he cites the large Seattle experience with mobile coronary care, reported by Cobb and his associates.2 Having followed-up over a two-year period a group of patients resuscitated after their unheralded first attack of ventricular fibrillation, these investigators found, to their surprise, a lower mortality among patients in whom myocardial infarction developed after resuscitation than among