Prolonged cardiac arrest (CA) in patients with acute myocardial infarction can be associated with poor prognosis. Successful revascularization with primary percutaneous coronary intervention (pPCI) remains the reference therapy for these patients. However, performing a pPCI during CA is challenging and the use of automatic chest compression devices or mechanical support systems might be warranted to facilitate the pPCI procedure and achieve good outcomes. We present a patient with inferior myocardial infarction and cardiogenic shock, followed by refractory CA who underwent successful pPCI with a novel approach integrating the simultaneous use of an automated chest compression system and intra-aortic balloon pump counterpulsation.