This double-blind, randomised trial compared amiodarone, lidocaine and placebo in out-of-hospital cardiac arrest for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia. Paramedics enrolled patients at 10 North American sites. 3026 patients were randomly assigned to amiodarone, lidocaine or placebo; of those 24.4%, 23.7% and 21.0% respectively survived to hospital discharge. There were no significant differences in the survival rate or neurological outcomes between the 3 groups. This study concluded that neither amiodarone nor lidocaine resulted in a significantly higher rate of survival or favourable neurological outcome than the rate with placebo among patients with out-of-hospital cardiac arrest due to initial shock-refractory VF or pulseless VT.