1. Clinical phase: which lasts 0–5 minutes where ventricular fibrillation is the main electrical activity and the treatment of choice is defibrillation followed by chest compression cardiac resuscitation [CCCR].
2. Hemodynamic phase: which lasts 5–10 minutes. Ventricular fibrillation persists and the patient, in addition, has hemodynamic instability. These patients require effective two minutes of chest compression cardiac resuscitation [CCCR] before defibrillation is attempted followed by two minutes of CCCR again.
3. Metabolic phase: phase beyond 10 minutes. Only hypothermia system can work here.
About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association, Past Academic and Research Wing Head IMA, Chairman Ethics Committee Delhi Medical Council.
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