- Asistol
- Asystole
- Ictal asystole
- Defibrillation
- Flatline
- Cardiac arrest
- Agonal heart rhythm
- Pulseless electrical activity
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- Asystole: Causes, Symptoms and Treatment - Cleveland Clinic
- What Is Asystole? Causes, Symptoms, Treatment - WebMD
- Asystole - Wikipedia
- Asystole: Definition, Causes, Treatment, Outlook - Healthline
- Asystole - StatPearls - NCBI Bookshelf - National Center for ...
- Asystole and its treatment | ACLS-Algorithms.com
- Asystole: Definition, Causes, Treatment and ECG Example
- Asystole | Diagnosis & Disease Information - The Cardiology Advisor
- Asystole (Nursing) - StatPearls - NCBI Bookshelf
- Asystole - ACLS Wiki
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Asystole (New Latin, from Greek privative a "not, without" + systolē "contraction") 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). 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.
Asystole should not be confused with very brief pauses below 3 seconds in the heart's electrical activity that can occur in certain less severe abnormal rhythms. Asystole is different from very fine occurrences of ventricular fibrillation, though both have a poor prognosis, and untreated fine VF will lead to asystole. Faulty wiring, disconnection of electrodes and leads, and power disruptions should be ruled out.
Asystolic patients (as opposed to those with a "shockable rhythm" such as coarse or fine ventricular fibrillation, or unstable ventricular tachycardia that is not producing a pulse, which can potentially be treated with defibrillation) usually present with a very poor prognosis. Asystole is found initially in only about 28% of cardiac arrest cases in hospitalized patients, but only 15% of these survive, even with the benefit of an intensive care unit, with the rate being lower (6%) for those already prescribed drugs for high blood pressure.
Asystole is treated by cardiopulmonary resuscitation (CPR) combined with an intravenous vasopressor such as epinephrine (a.k.a. adrenaline). Sometimes an underlying reversible cause can be detected and treated (the so-called "Hs and Ts", an example of which is hypokalaemia). Several interventions previously recommended—such as defibrillation (known to be ineffective on asystole, but previously performed in case the rhythm was actually very fine ventricular fibrillation) and intravenous atropine—are no longer part of the routine protocols recommended by most major international bodies. 1 mg epinephrine by IV every 3–5 minutes is given for asystole.
Survival rates in a cardiac arrest patient with asystole are much lower than a patient with a rhythm amenable to defibrillation; asystole is itself not a "shockable" rhythm. Even in those cases where an individual suffers a cardiac arrest with asystole and it is converted to a less severe shockable rhythm (ventricular fibrillation, or ventricular tachycardia), this does not necessarily improve the person's chances of survival to discharge from the hospital, though if the case was witnessed by a civilian, or better, a paramedic, who gave good CPR and cardiac drugs, this is an important confounding factor to be considered in certain select cases. Out-of-hospital survival rates (even with emergency intervention) are less than 2 percent.
Cause
Possible underlying causes, which may be treatable and reversible in certain cases, include the Hs and Ts.
Hypovolemia
Hypoxia
Hydrogen ions (acidosis)
Hypothermia
Hyperkalemia or hypokalemia
Toxins (e.g. drug overdose)
Cardiac tamponade
Tension pneumothorax
Thrombosis (myocardial infarction or pulmonary embolism)
While the heart is asystolic, there is no blood flow to the brain unless CPR or internal cardiac massage (when the chest is opened and the heart is manually compressed) is performed, and even then it is a small amount. After many emergency treatments have been applied but the heart is still unresponsive, it is time to consider pronouncing the patient dead. Even in the rare case that a rhythm reappears, if asystole has persisted for fifteen minutes or more, the brain will have been deprived of oxygen long enough to cause severe hypoxic brain damage, resulting in brain death or persistent vegetative state.
See also
Agonal heart rhythm
Ictal asystole
References
External links
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ASYSTOLE. Medical Definition of Asystole. Pathophysiology. Prognosis ...
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Asystole: Causes, Symptoms and Treatment - Cleveland Clinic
Asystole is a dangerous problem that happens with cardiac arrest. Without quick action and CPR, the odds of survival are very low. However, the odds of survival are much higher when a person in cardiac arrest receives CPR quickly and effectively. Knowing how to do CPR and being prepared are critical, and the faster a person with asystole gets ...
What Is Asystole? Causes, Symptoms, Treatment - WebMD
Aug 5, 2024 · Asystole, also known as the most serious form of cardiac arrest, is when your heart stops beating or when you flatline. Learn what causes this condition and if it can be reversed.
Asystole - Wikipedia
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). Asystole is the most serious form of cardiac arrest …
Asystole: Definition, Causes, Treatment, Outlook - Healthline
Jul 22, 2022 · Asystole is the most urgent and serious type of cardiac arrest. Survival rates are low, but immediately starting vigorous CPR and injecting epinephrine may help improve the odds of survival. How ...
Asystole - StatPearls - NCBI Bookshelf - National Center for ...
Apr 20, 2024 · Asystole, colloquially referred to as "flatline," represents the cessation of electrical and mechanical cardiac activity. Consequently, blood flow to other vital organs also stops. The condition typically occurs as a deterioration of the initial nonperfusing ventricular rhythms, ventricular fibrillation and pulseless ventricular tachycardia.
Asystole and its treatment | ACLS-Algorithms.com
Asystole for many patients is the result of a prolonged illness or cardiac arrest, and prognosis is very poor. Few patients will likely have a positive outcome and successful treatment of cardiac arrest with asystole will usually involve the identification and correction of …
Asystole: Definition, Causes, Treatment and ECG Example
Treating Asystole. Standard asystole treatment involves cardiopulmonary resuscitation, or CPR, and intravenous administration of epinephrine given every three to five minutes as needed. When a reversible underlying cause is found, that cause should be treated directly to reverse asystole. Some theoretically reversible causes of asystole include:
Asystole | Diagnosis & Disease Information - The Cardiology Advisor
Jan 23, 2024 · Cardiac arrest that results from the total failure of the cardiac electrical system is called asystole or flat-lining. 1 Asystole is a medical emergency that requires immediate recognition and intervention. This article will review the causes of asystole and the methods for diagnosing and treating patients with this condition.
Asystole (Nursing) - StatPearls - NCBI Bookshelf
Apr 20, 2024 · Asystole, colloquially referred to as flatline, represents the cessation of electrical and mechanical activity of the heart. Asystole typically occurs as a deterioration of the initial non-perfusing ventricular rhythms: ventricular fibrillation (V-fib) or pulseless ventricular tachycardia (V-tach). Additionally, pulseless electrical activity (PEA) can cease and become asystole. Victims …
Asystole - ACLS Wiki
The term asystole simply refers to an absence of ventricular activity, which means the patient will exhibit no discernible electrical activity on an ECG readout. In most cases, asystole is a lethal arrhythmia and survival is extremely rare. Asystole is a cardiac standstill. It is represented by a straight flat, or almost flat, line on an ECG.