[Cardiac arrest over the Atlantic.]

The following case report is of the cardiac arrest of a 63 year old male on board a transatlantic passenger aircraft. Medical doctors on board the aircraft used an automated external defibrillator (AED) which restored the patient circulation. On arrival at the hospital in Iceland two hours later he was unconscious and had EKG signs of an antero-septal myocardial infarction. He received thrombolytic therapy, was intubated and kept hypothermic in the ICU. On coronary angiography he had stenosis of the left anterior diagonal artery which was dilated and stented. Twelve days after the cardiac arrest the patient was discharged from the hospital and was scheduled to return to his prior occupation shortly thereafter. Automated external defibrillators have proven to be save and effective in the resuscitation of cardiac arrest patient in hospital and prehospital settings. We review the literature on their use, and the benefits and costs involved for the major Icelandic airline company installing the AEDs.