SUCCESSFUL resuscitation of a patient from unexpected cardiac standstill in 1941 aroused our interest in this problem.1As a result of this encouraging experience, a program for the management of cardiac arrest was developed, emphasizing early diagnosis, intracardiac injection of procaine-epine-phrine solutions, and thoracotomy with manual systole.2In addition, more attention was directed toward the preoperative correction of predisposing factors, such as reduced blood volume, dehydration, electrolyte imbalance, and cardiorespiratory disorders. Despite this concerted effort, the incidence of cardiac asystole and its mortality rate remained alarmingly high in our clinical practice.3From 1941 to 1947, cardiac standstill was treated with manual systole (thoracotomy) in 13 cases; only five of these patients (38%) recovered. A similar high mortality rate has apparently remained in the practice of others (Table 1). It became increasinglyclear that prompt diagnosis and immediately effective treatment were of paramount importance. Lacking these two essential