Denominator All patients with STEMI who are comatose after resuscitated out-of-hospital cardiac arrest (VF or pulseless VT) Denominator Exclusions Patients age <18 y Patients who die shortly after arrival (<12 h) Patients who become comfort care measures only or hospice shortly after arrival (<12 h) Patients who are transferred to another hospital for inpatient care shortly after arrival (<12 h) Patients received in transfer from the inpatient setting from another facility Denominator Exceptions Documentation of a medical reason for not receiving therapeutic hypothermia for comatose STEMI patients with out-of-hospital cardiac arrest (eg, intracranial hemorrhage, severe/active bleeding, significant hypotension refractory to multiple vasopressors, severe sepsis, pregnancy, other evidence of medical futility) Measurement Period Encounter Sources of Data Medical record or other database (eg administrative, clinical, registry) Attribution Measure reportable at the facility or provider level Care Setting Inpatient Rationale Therapeutic hypothermia in comatose patients with acute MI after certain types of cardiac arrest (predominantly related to VF or pulseless VT) has been shown to improve outcomes (eg, increased survival to hospital discharge with good neurologic function, higher rate of a favorable neurologic outcome, and possibly reduced intermediate-term mortality).12,192 194 Clinical Recommendation(s) 2013 ACCF/AHA Guideline for the Management of Patients With ST-Elevation Myocardial Infarction12 1. Therapeutic hypothermia should be started as soon as possible in comatose patients with STEMI and out-of-hospital cardiac arrest caused by ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), including patients who undergo primary PCI.192 194 (Class I, Level of Evidence: B) ACCF indicates American College of Cardiology Foundation; AHA, American Heart Association; LBBB, left bundle branch block; MI, myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction; VF, ventricular fibrillation; and VT, ventricular tachycardia. Appendix A. 