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January 16, 1967


JAMA. 1967;199(3):210. doi:10.1001/jama.1967.03120030114022

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The death rate from myocardial infarction has remained relatively unaltered in the past 30 years. Eighty-five percent of the deaths occur during the first week after onset of infarction; nearly half of these patients die as a direct consequence of arrhythmias. Recent experience indicates that these electrical catastrophes are ordinarily not caused by nor need they result in irreversible cardiac damage. Recognition of the importance of the prompt treatment of arrhythmias has resulted in the establishment of special areas designated as coronary care units for the observation of patients with acute myocardial infarction. Although these sophisticated diagnostic and therapeutic areas have resulted in some decrease in the number of electrical cardiac deaths, the overall figure for long-range recovery after resuscitation is a distressingly low 38%. Has the concept of the coronary care unit been implemented for maximal benefit, or can we modify current regimens so that more patients can be