Although there are many books on ischemic heart disease and myocardial in­ farction, very few relate to the acute phase of the illness. Pre-hospital coronary care units have been operational for over a decade. In 1975 the first book detailing the operation and results of the out-of-hospital Belfast Mobile Coronary Care Unit was published (The Acute Coronary Attack - Pitman Medical). Nevertheless, deaths due to coronary artery disease still remain a major challenge in contemporary society. Sudden death is largely an out-of-hospital problem. Since ventricular fibril­ lation is an electrical accident and can be readily corrected when a limited area of the ventricle is depolarized, methods for its containment are essential. The purpose of this book is to project the recent advances in the acute phase of ischemic heart disease. The early chapters document the history and recent develop­ ments in the understanding of ventricular fibrillation, ventricular defibrillation and cardiopulmonary resuscitation. The etiology of ventricular arrhythmias in the acute phase of myocardial ischemia in experimental animals is discussed with particular reference to the antiarrhythmic action of drugs. Factors observed in the initiation of ventricular fibrillation in patients outside the hospital are reviewed. The practical applications both in the field of biomedical engineering as applied to mobile coro­ nary care and in the approach and impact of pre-hospital coronary care in the various communities in the United States of America, Canada, United Kingdom, and other countries in Europe are presented.