The final nail in the coffin for immediate catheterization for refractory cardiac arrest with ongoing chest compressions.

In a cohort of 219 patients with out of hospital cardiac arrest, survival correlated with age, initial shockable rhythm, recovery of spontaneous circulation (ROSC) before starting catheterization, and initial pH. Mortality was 98% in patients who underwent catheterization before ROSC. Early studies of emergency extra-corporeal membrane oxygenation life support combined with hypothermia, and coronary intervention, suggest this "hyper-invasive" strategy may offer significant improvement in outcomes compared to conventional strategies employed in this study.