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There is yet more evidence showing that a simpler and easier way to perform CPR — using chest compressions only — saves lives just as well as traditional CPR and its mouth-to-mouth breathing.

As a result, that easier method should be taught worldwide instead of the old method, because people are much more likely to use it on victims of sudden cardiac arrest, say the University of Arizona scientists who developed it.

Cardiac arrests that occur outside the hospital kill nearly 400,000 Americans every year — second only to all cancer deaths combined.

The "new CPR" — eliminating the need for mouth-to-mouth breathing — was unveiled in 2003 after a decade of research by UA cardiac experts, who have worked for its widespread acceptance ever since.

They received new ammunition for their argument this week with the results of two large international studies comparing the two CPR methods.

When performed by bystanders who witnessed a person collapse from cardiac arrest, the two methods achieved similar survival rates for the victims, the studies — in Sweden and Japan — found.

In the larger study, of nearly 10,000 Swedish patients who suffered sudden cardiac arrest (usually from a heart attack or arrhythmia), about 7 percent were saved by bystanders who performed CPR using either mouth-to-mouth breathing with chest compressions, or chest compressions only.

In a similar study of about 5,000 Japanese patients, around 4 percent were saved by people using the traditional CPR or chest-compression-only CPR.

Both methods of CPR were significantly more effective than what usually happens when a person collapses in public: Bystanders call 911 and do nothing but wait.

When that happens, fewer than 3 percent survive a sudden cardiac arrest.

The studies were published in this week's edition of Circulation, the journal of the American Heart Association.

These and other studies — several of which have shown chest-compression-only CPR produces better survival rates — should persuade the American Heart Association to issue new guidelines recommending the new method be used universally by citizens who witness an out-of-hospital cardiac arrest, said Dr. Gordon Ewy, director of the UA Sarver Heart center.

One of the major reasons most people do nothing but call for help is the widespread reluctance to give a stranger mouth-to-mouth, which most think is required in such an emergency, said Ewy, one of the pioneers of the new compression-only CPR.

It isn't, as the two new studies once again show, Ewy argues in an editorial in Circulation.

"Mouth-to-mouth ventilations are not essential for survival in the vast majority of patients with out-of-hospital cardiac arrest," he wrote. "The recommendation for so-called rescue breathing is a major impediment to performing the first crucial link in the chain of survival," meaning bystander CPR on the collapsed victim.

In addition to the fact that people are much more likely to perform CPR if only chest compression is required, Ewy stressed that adding mouth-to-mouth breathing actually interrupts the crucial restoration of blood flow to the brain and heart provided by the chest compressions.

Bolstering his argument was a large study published earlier this year in the prestigious British medical journal Lancet, which showed that chest-compression-only CPR produced the best survival rates with the least brain damage in patients who are reached quickly and still have some heart rhythm.

These are the patients most likely to respond to help, and chest-only CPR is the most effective method, it concluded.

Despite the mounting evidence supporting the new CPR, the American Heart Association has stopped short of eliminating mouth-to-mouth breathing from its CPR guidelines. These guidelines dictate what is taught in CPR classes by the American Red Cross.

This is in part because of the concern that most people cannot tell if a person has collapsed from cardiac or respiratory arrest. Chest-only CPR works for cardiac arrest but not the more rare respiratory arrest — involving drowning or choking — which does require mouth-to-mouth resuscitation because the airway is blocked.

However, the heart association did recognize the superior effect of chest compressions two years ago when it changed CPR technique to require more of them — 30 hard, fast chest compressions before two mouth breaths, instead of two breaths for every 15 compressions.

But as Ewy pointed out in the Circulation editorial, "millions of dollars and millions of hours" have been spent to teach traditional CPR worldwide, yet it works no better than chest-compression-only, at this point rarely taught and usually done by people with no training.

"It is now time to change the guidelines," he wrote.