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Asystole is the most serious form of cardiac arrest and is usually irreversible. Also referred to as cardiac flatline, asystole is the state of total cessation of electrical activity from the heart, which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.
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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]
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.
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.
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]
This sinus rhythm is important because it ensures that the heart's atria reliably contract before the ventricles, ensuring as optimal stroke volume and cardiac output. [ 4 ] In junctional rhythm, however, the sinoatrial node does not control the heart's rhythm – this can happen in the case of a block in conduction somewhere along the pathway ...