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Background  Extracorporeal membrane oxygenation (ECMO) technology is a viable option for short-term support in the setting of acute cardiac ischemia. To supplement cardiopulmonary resuscitation (CPR) in select patients, ECMO is used successfully for witnessed in hospital cardiac arrest. In the setting of an acute myocardial infarction (MI), bridging to a revascularization procedure is important in improving overall survival.    Case presentation  We describe the first known case of a 56-year-old Caucasian male with an anterior ST elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI) in which the entire procedure was carried out with the patient being in persistent ventricular fibrillation (VF) resistant to defibrillation on ECMO support. Subsequent to revascularization, the patient’s cardiac rhythm converted back to sinus rhythm with a single defibrillation shock with excellent neurologic recovery.    Conclusion  Our case highlights the importance of early initiation of ECMO during PCI in achieving both improved cardiac and neurological outcomes during an acute coronary syndrome (ACS).

Successful cardiac resuscitation with extracorporeal membrane oxygenation in the setting of persistent ventricular fibrillation: a case report