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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.
ECG flatline or asystole is diagnosed when a person, who is in cardiac arrest (the heart stops beating), is experiencing the following conditions: unresponsive to stimuli, without breathing or a palpable pulse. [2] The eclectrocardiogram (ECG) test records the heart's electrical activity and will show a flat line if the heart stops beating. [2]
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]
Cardiac arrhythmias are another possible cause. Arrhythmias such as asystole or bradycardia are more likely in children, in contrast to ventricular fibrillation or tachycardia as seen in adults. [30] Additional causes of sudden unexplained cardiac arrest in children include hypertrophic cardiomyopathy and coronary artery abnormalities. [160]
Electrical waves track a systole (a contraction) of the heart. The end-point of the P wave depolarization is the start-point of the atrial stage of systole. The ventricular stage of systole begins at the R peak of the QRS wave complex; the T wave indicates the end of ventricular contraction, after which ventricular relaxation (ventricular diastole) begins.
Transcutaneous pacing is no longer indicated for the treatment of asystole (cardiac arrest associated with a "flat line" on the ECG), with the possible exception of witnessed asystole (as in the case of bifascicular block that progresses to complete heart block without an escape rhythm). [4]
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Technically, this means arresting or stopping the heart so that surgical procedures can be done in a still and bloodless field. Most commonly, however, the word cardioplegia refers to the solution used to bring about asystole of the heart, or heart paralysis. One of the first physicians to use the term cardioplegia was Dr. Lam in 1957.