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Amiodarone, lidocaine or placebo for out-of-hospital cardiac arrest due to ventricular fibrillation or tachycardiaThe goal of ALPS is to determine if survival to hospital discharge is improved with early (and if necessary) repeated therapeutic administration of a new Captisol-Enabled formulation of IV amiodarone (PM101) compared to no antiarrhythmic drug (placebo) or lidocaine. It will compare the benefit of what is believed (but as yet unproven) to be the most effective antiarrhythmic drug (amiodarone) against the traditional standard drug (lidocaine) and against neither (placebo) in shock-resistant cardiac arrest. As such, it will potentially answer 2 critical questions: (1) are antiarrhythmic drugs effective for the treatment of VF cardiac arrest? (2) is amiodarone preferable to lidocaine for such treatment? Answering these questions will determine the proven role (if any) of antiarrhythmic drugs for future generations of patients with out-of-hospital cardiac arrest. Antiarrhythmic medications (amiodarone, lidocaine) are frequently used as part of advanced care to treat ventricular arrhythmias that persist or recur during a cardiac arrest. Although much is known about the pharmacological effects of these drugs, there is a considerable gap in knowledge between our understanding of their mechanisms of action and whether their use actually improves survival after cardiac arrest. No pharmacologic agent has ever been demonstrated to improve survival to hospital discharge after cardiac arrest. It is not known whether these drugs may cause more harm than good. The study will be done at 10 locations across the U.S. and Canada. Almost 70 EMS organizations, involving more than 10,000 EMS providers who serve a combined population of nearly 15 million people from diverse urban, suburban and rural regions will participate in the ROC Continuous Cardiac Compressions study. Approximately 3,000 patients will be enrolled at all of the ROC regions in the United States and Canada. The study is expected to last approximately 3 years. The ClinicalTrials.gov registration number is NCT01401647.