Perspective:

Long-term outcomes following out-of-hospital cardiac arrest (OHCA) remain dismal, with a 5-10% survival rate. Optimal post-resuscitation care is the key to improving the proportion that not only survive long-term, but also survive with favorable neurological function. Mild therapeutic hypothermia has become the basis for improvement of neurologically favorable survival following cardiac arrest. Reperfusion therapy, specifically early percutaneous coronary intervention (PCI), is also becoming an important adjunct to therapeutic hypothermia. Increasing clinical experience suggests that resuscitated cardiac arrest victims without an obvious noncardiac etiology should undergo emergency coronary angiography and, where indicated, PCI. If comatose, they should receive concurrent therapeutic hypothermia. Such approaches can double long-term survival rates among those successfully resuscitated after OHCA. The role of the interventional cardiologist is crucial in providing this optimal post–cardiac arrest care since the two most important aspects of post-resuscitation care are therapeutic hypothermia and early coronary angiography with potential PCI.