Treatment of cardiac arrest requiring CPR has been transformed by the use of extra-corporeal membrane oxygenation. Patient stabilised on this innovative therapy can be transferred for coronary angiography and possible stent intervention. Time is critical, time is muscle! However, when the muscle is gone but the other organs still work what options do we now have? For the patient in sustained unrecoverable cardiogenic shock with neurology intact where should we go? What therapies are appropriate and possible?