We have reported previously that simultaneous sterno-thoracic cardiopulmonary resuscitation (SST-CPR) using a device that compresses the sternum and constricts the thorax circumferentially during a compression systole that can be achieved using standard cardiopulmonary resuscitation (STD-CPR). This study was designed to assess whether SST-CPR improves the survival rate of dogs with cardiac arrest compared with STD-CPR. Twenty-nine mongrel dogs (19-31 kg) were enrolled in this study. After 4 min of ventricular fibrillation induced by an AC current, animals were randomized to be resuscitated by either STD-CPR (n=15) or SST-CPR (n=14). Defibrillation was attempted 10 min after the induction of cardiac arrest. Standard advanced cardiac life support was started if defibrillation was unsuccessful. Aortic blood pressure, coronary perfusion pressure, and end tidal CO(2) tension were measured during CPR and the post-resuscitation period. Survival was determined 12 h after the induction of cardiac arrest. SST-CPR resulted in a significantly (P<0.001) higher systolic arterial pressure (91+/-47 vs 47+/-24 mmHg), diastolic pressure (43+/-24 vs 17+/-10 mmHg), coronary perfusion pressure (35+/-25 vs 13+/-9 mmHg), and end tidal CO(2) tension (9+/-4 vs 3+/-2 mmHg). Two of 15 animals (13%) resuscitated by STD-CPR and seven of 14 animals (50%) resuscitated by SST-CPR survived for 12 h after cardiac arrest (P<0.05). In conclusion, SST-CPR improves the short-term survival rate in canine cardiac arrest compared with STD-CPR.