The truth about shocking ventricular tachycardia and ventricular fibrillation.

n this issue of the Journal, Zafari et al. (1) report a pectacular improvement in survival after in-hospital cariopulmonary resuscitation (CPR), which they attribute to a rogram of training and an equipment upgrade. The findngs may have important general implications for the ractice of resuscitation both in and outside of the hospital etting. The study, restricted to a single hospital (the Atlanta eteran Affairs Medical Center [VAMC]), sought to meaure the effect on survival from cardiac arrest of a multifacted CPR-improvement program that included replacement f monophasic with biphasic waveform electric cardioverters hroughout the hospital. Survival after the intervention mproved 2.6-fold overall and by 14-fold in patients with entricular tachycardia (VT) or ventricular fibrillation (VF). lthough this outstanding result is not ambiguous, the easons for it are.