I read with interest the article “Cardiac Arrest Centers May Improve Survival” (ACEP News, March 2009, p. 1). I would like to add a few comments:

1. There were no literature references to substantiate the improved survival numbers, and it appears to be anecdotal numbers provided by these hospitals. It is hard to draw conclusions without more data and references. I realize that ACEP News is not a peer-reviewed journal, but medical statements are being made, and it would be better if the reader could obtain better information.
2. The Take Heart America initiative is funded by various commercial entities, and it is always difficult to draw scientific conclusions with such strong commercial connections, as well as statements that the hospitals were making money on these patients.
3. Commenting on the improved survival rate, that may be due to a selected population. Arrest survivors who make it to a hospital or even a referral center are a different population than the general arrest population—that is, they may already have an inherently better survival rate irrespective of the post-arrest treatments performed.

I am reminded of a story once told to me about an Indian mystic who was able to cure all cobra bites. Later, when he was asked on his death bed to reveal the secret of his great cure rate, he stated that anyone with a cobra bite who was able to make it all the way to his mountain cave was already cured or not ill.

I enjoy ACEP News, but I believe we have to remain scientific and as commercial free as possible.

Helmut Meisl, M.D.

San Jose, Calif.