The coronary care unit. New perspectives and directions

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Abstract
The organization of a coronary care unit provided with continuous electrocardiographic monitoring and staffed with trained nurses permits immediate detection of arrhythmias and prompt institution of therapy. The abolition of minor rhythm disorders precludes development of major electrical failures of the heart. Among 130 consecutive unselected patients with myocardial infarction admitted to the coronary care unit, there was not a single instance of primary ventricular fibrillation. Of 15 deaths within the coronary care unit, 13 were due to either shock or intractable heart failure. Two patients died from complete heart block. The focus of management in the coronary care unit should be altered from resuscitation to the prevention of the need for resuscitation.