A Study of the Usefulness and Limitations of Electrical Countershock, Cardiac Massage, Epinephrine and Procaine in Cardiac Resuscitation from Ventricular Fibrillation

The efficacy of electrical countershock, cardiac massage, epinephrine and procaine in stopping ventricular fibrillation and restoring a competent ventricular contraction was studied in anesthetized dogs. It was found that countershock is a reliable means of stopping fibrillation. However, it must be preceded by cardiac massage if not applied promptly after the initiation of fibrillation. Epinephrine helps restore a competent ventricular contraction once fibrillation has been stopped by countershock but it increases the incidence of recurrence of fibrillation. The doses of procaine which constitute a reliable means of stopping fibrillation depress the rhythmicity of the heart to such an extent that the cessation of fibrillation is followed by prolonged periods of cardiac standstill.