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Asystole (New Latin, from Greek privative a "not, without" + systolē "contraction" [1] [2]) is the absence of ventricular contractions in the context of a lethal heart arrhythmia (in contrast to an induced asystole on a cooled patient on a heart-lung machine and general anesthesia during surgery necessitating stopping the heart).
Flatlined ECG lead. A flatline is an electrical time sequence measurement that shows no activity and therefore, when represented, shows a flat line instead of a moving one. It almost always refers to either a flatlined electrocardiogram, where the heart shows no electrical activity [1] (), or to a flat electroencephalogram, in which the brain shows no electrical activity (brain death).
If these fail to respond to atropine or there is a potential risk of asystole, transvenous pacing is indicated. The risk factors for asystole include 1) previous asystole, 2) complete heart block with wide complexes, and 3) ventricular pause for > 3 seconds. Mobitz Type 2 AV block is another indication for pacing.
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On ECG, the PR interval is unchanged from beat to beat, but there is a sudden failure to conduct the signal to the ventricles, and resulting in random skipped beat. [4] The risks and possible effects of Mobitz II are much more severe than Mobitz I in that the risk of progression to complete heart block or asystole are significant. [5] [6]
In medicine, an agonal heart rhythm is a variant of asystole. Agonal heart rhythm is usually ventricular in origin. Occasional P waves and QRS complexes can be seen on the electrocardiogram. The complexes tend to be wide and bizarre in morphological appearance. [1]
Less common types of arrhythmias occurring in cardiac arrest include pulseless electrical activity, bradycardia, and asystole. [30] These rhythms are seen when there is prolonged cardiac arrest, progression of ventricular fibrillation, or efforts like defibrillation executed to resuscitate the person. [30]
Pulseless electrical activity (PEA) is a form of cardiac arrest in which the electrocardiogram shows a heart rhythm that should produce a pulse, but does not.Pulseless electrical activity is found initially in about 20% of out-of-hospital cardiac arrests [1] and about 50% of in-hospital cardiac arrests.