A community-wide study was conducted in metropolitan Baltimore in which the prognosis of 330 patients hospitalized with an acute myocardial infarction (MI) complicated by ventricular fibrillation or cardiac arrest (VFib/CA) was compared with that of 1,071 patients hospitalized with acute MI not complicated by VFib/CA. As expected, the in-hospital case-fatality rate among patients with MI complicated by VFib/CA was significantly higher than that in patients without VFib/CA. However, for patients discharged alive from the hospital, no significant differences in long-term survival were found between patients with MI with or without VFib/CA. These results suggest that attempts at preventing subsequent mortality should be diligently pursued in patients with MI who are discharged alive from the hospital regardless of the occurrence of VFib/CA in the acute phase.