TUESDAY, Sept. 23 (Health.com) — It always seems so straightforward on TV. You have a cardiac arrest, a handsome doctor rushes to your side, shouts “Clear!” and gives you a couple of zaps to the chest with electricity-generating paddles, and—ta-da!—you’re back in business. Cue the tears and music.

But in reality, a cardiac arrest is a much more complicated business, and one with considerably more peril than you might realize. One study shows that the chances of surviving a cardiac arrest outside a hospital are slim indeed—around 1 in 22 (about 1 in 12 if someone tries resuscitation).

However, your chances are also better in some cities than others, according to the study published in the Journal of the American Medical Association.

In fact, if you have to pick a city to have a cardiac arrest in, I’d say Seattle is probably your best bet. For example, 16% of people who were treated in Seattle for a cardiac arrest outside of a hospital survived, compared to 3% in Alabama.

And nearly 40% of those with ventricular fibrillation—a condition in which the heart quivers with uncoordinated contractions but hasn’t completely stopped—survived in Seattle, compared to about 8% of those in Alabama.

The researchers are still trying to track down the reasons why some cities have better survival rates than others. However, a variety of factors play a role, including:

• Whether bystanders attempt cardiopulmonary resuscitation (CPR)
• What emergency workers do when they get to the scene
• What happens at the hospital later on

Next: A cardiac arrest is not a heart attack