To the Editor.
—A number of studies concerning the circadian distribution of human mortality were published over the last ten years.13 Mitler et al2 reported on 4920 disease-related deaths randomly sampled from death certificates at the New York City Bureau of Vital Statistics for 1979. There were 2463 deaths in that sample that were recorded as being due to ischemic heart disease. Deaths attributed to ischemic heart disease showed a prominent and statistically significant rhythm, with a peak at 8 AM.Muller et al4 reported on a morning peak in the incidence of myocardial infarction. There appears to be a rhythm in the frequency of ischemic events characterized by a rise from a low point at 2 AM to a high point sometime between 8 and 11 AM, and by a secondary peak between 6 and 8 PM.We reviewed 395 resuscitation attempts that were performed by