[Acute cardiovascular failure and its treatment--value of defibrillation in preclinical management]

Ventricular fibrillation is the most common cause of cardiac arrest. The only scientifically proved therapy that guarantees a long time survival is the early electrical defibrillation. As early as 200 years ago electricity was employed in trying to regain circulation in cases of unexpected death. In the field of emergency medicine almost all rescue services are equipped with defibrillators nowadays and the personnel is trained in using them. Since the application of electricity on the myocardium can lead to damage, there are devices with a varied defibrillation pulse available since recently. The advantage of the biphasic defibrillation is a less harmful impact on the myocardium at lower shock intensity. A further novelty which enables the application by groups other than the rescue services, is the automatic external defibrillator (AED). Extending the availability of defibrillators can contribute to an increase in the presently low success rates of resuscitation.