333:
112:
357:
214:
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.
345:
40:
213:
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
581:
Neumar, R. W.; Otto, C. W.; Link, M. S.; Kronick, S. L.; Shuster, M.; Callaway, C. W.; Kudenchuk, P. J.; Ornato, J. P.; McNally, B.; Silvers, S. M.; Passman, R. S.; White, R. D.; Hess, E. P.; Tang, W.; Davis, D.; Sinz, E.; Morrison, L. J. (17 October 2010).
782:
ECC Committee, Subcommittees and Task Forces of the
American Heart Association (December 2005). "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care â Part 7.2: Management of Cardiac Arrest".
307:(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
206:). Several interventions previously recommendedâsuch as defibrillation (known to be ineffective on asystole, but previously performed in case the rhythm was actually very fine ventricular fibrillation) and intravenous
159:
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
886:
871:
856:
537:
Kempton, Hannah; Vlok, Ruan; Thang, Christopher; Melhuish, Thomas; White, Leigh (March 2019). "Standard dose epinephrine versus placebo in out of hospital cardiac arrest: A systematic review and meta-analysis".
175:) 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
164:, 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.
311:. 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
584:"Part 8: Adult Advanced Cardiovascular Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care"
210:âare no longer part of the routine protocols recommended by most major international bodies. 1 mg epinephrine by IV every 3â5 minutes is given for asystole.
1598:
453:
Baldzizhar, Aksana; Manuylova, Ekaterina; Marchenko, Roman; Kryvalap, Yury; Carey, Mary G. (September 2016). "Ventricular
Tachycardias".
1239:
650:"Survival in Out-of-Hospital Cardiac Arrests with Initial Asystole or Pulseless Electrical Activity and Subsequent Shockable Rhythms"
929:
332:
1656:
973:
167:
Asystolic patients (as opposed to those with a "shockable rhythm" such as coarse or fine ventricular fibrillation, or unstable
766:
733:
1460:
1297:
1651:
1465:
1455:
1044:
418:
1762:
1593:
1207:
2012:
1633:
1628:
1497:
1278:
1573:
1568:
1492:
156:, which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.
781:
1919:
1795:
1724:
1556:
1292:
300:
187:
2017:
1914:
1707:
1690:
1623:
1543:
922:
198:(a.k.a. adrenaline). Sometimes an underlying reversible cause can be detected and treated (the so-called "
2027:
1757:
1202:
435:
404:
323:
1739:
1227:
1212:
430:
1286:
1817:
1514:
1482:
1409:
1136:
2022:
1941:
1767:
1697:
1487:
1384:
1365:
1195:
968:
356:
304:
161:
111:
1974:
1948:
1936:
1924:
1909:
1643:
1585:
1389:
1370:
1022:
962:
915:
488:
Kutsogiannis, Demetrios J.; Bagshaw, Sean M.; Laing, Bryce; Brindley, Peter G. (4 October 2011).
168:
222:
Possible underlying causes, which may be treatable and reversible in certain cases, include the
1563:
1529:
1472:
1450:
1272:
1254:
1190:
1057:
1010:
938:
47:
A rhythm strip showing two beats of normal sinus rhythm followed by an atrial beat and asystole
865:
758:
751:
1327:
1322:
1217:
1132:
1027:
288:
819:
1823:
1351:
1332:
1232:
1143:
1086:
279:
8:
1828:
1685:
1680:
1603:
1507:
1477:
1436:
1062:
979:
890:
373:
176:
665:
1931:
1729:
1551:
1502:
1127:
1074:
984:
674:
649:
563:
514:
489:
292:
144:
during surgery necessitating stopping the heart). Asystole is the most serious form of
141:
137:
895:
796:
710:
600:
583:
1991:
1842:
1800:
1715:
1533:
1431:
1148:
1091:
989:
800:
762:
729:
679:
630:
605:
555:
519:
470:
274:
235:
132:"contraction") is the absence of ventricular contractions in the context of a lethal
100:
567:
1964:
1856:
1749:
1445:
792:
706:
669:
661:
595:
547:
509:
501:
490:"Predictors of survival after cardiac or respiratory arrest in critical care units"
462:
312:
133:
60:
1986:
1378:
1359:
1346:
1153:
1032:
907:
440:
624:
1979:
1887:
1785:
1777:
1675:
1185:
1178:
1165:
648:
Thomas, Andrew; Newgard, Craig; Fu, Rongwei; Zive, Dana; Daya, Mohamud (2013).
551:
378:
172:
145:
880:
466:
2006:
1969:
1880:
1015:
426:
268:
399:
344:
1901:
1875:
1719:
1667:
1340:
1316:
1263:
1122:
804:
683:
634:
609:
559:
523:
474:
315:
255:
203:
152:, asystole is the state of total cessation of electrical activity from the
1836:
1734:
1524:
1441:
1423:
1249:
1222:
1173:
1114:
319:
299:
While the heart is asystolic, there is no blood flow to the brain unless
259:
250:
230:
195:
191:
180:
125:
505:
179:, with the rate being lower (6%) for those already prescribed drugs for
1864:
1414:
284:
105:
848:
223:
199:
171:
that is not producing a pulse, which can potentially be treated with
452:
947:
244:
240:
207:
697:"Medical Futility in Asystolic Out-of-Hospital Cardiac Arrest".
487:
1870:
1850:
1005:
875:
860:
623:
Jordan, Matthew; Lopez, Richard; Morrisonponce, Daphne (2022).
84:
81:
419:
264:
153:
136:(in contrast to an induced asystole on a cooled patient on a
39:
308:
63:
748:
72:
629:. Treasure Island, Florida (US): StatPearls Publishing.
622:
536:
728:. Dallas: American Heart Association. pp. 71â87.
580:
75:
69:
838:
749:
Barnes TG, Cummins RO, Field J, Hazinski MF (2003).
78:
647:
66:
937:
750:
820:"Asystole: Background, Pathophysiology, Etiology"
148:and is usually irreversible. Also referred to as
2004:
757:. Dallas: American Heart Association. pp.
742:
455:Critical Care Nursing Clinics of North America
923:
717:
775:
1240:Arrhythmogenic right ventricular dysplasia
930:
916:
540:The American Journal of Emergency Medicine
494:CMAJ: Canadian Medical Association Journal
110:
38:
673:
599:
513:
723:
2005:
974:Spontaneous coronary artery dissection
446:
911:
1298:Nonbacterial thrombotic endocarditis
817:
338:ECG lead showing asystole (flatline)
791:(24 Suppl): IV1â203 (7.2 IV58â66).
666:10.1016/j.resuscitation.2013.02.016
190:(CPR) combined with an intravenous
13:
1594:Accelerated idioventricular rhythm
397:
33:Cardiac flatline, asystolic arrest
14:
2039:
834:
797:10.1161/CIRCULATIONAHA.105.166550
711:10.1097/01.SA.0000318635.97636.a6
601:10.1161/CIRCULATIONAHA.110.970988
355:
343:
331:
59:
1279:Subacute bacterial endocarditis
818:Shah, Sandy (16 October 2021).
811:
753:ACLS for experienced providers
690:
641:
616:
574:
530:
481:
412:
391:
16:Medical condition of the heart
1:
1796:Pulseless electrical activity
1725:Multifocal atrial tachycardia
1599:Catecholaminergic polymorphic
726:ACLS: Principles And Practice
384:
188:cardiopulmonary resuscitation
705:(5): 261â262. October 2008.
7:
405:Online Etymology Dictionary
367:
324:persistent vegetative state
10:
2044:
1740:Wandering atrial pacemaker
1287:non-infective endocarditis
1228:Endocardial fibroelastosis
552:10.1016/j.ajem.2018.12.055
420:
202:", an example of which is
1957:
1900:
1818:hexaxial reference system
1809:
1776:
1763:Jervell and Lange-Nielsen
1748:
1706:
1665:
1642:
1616:
1584:
1542:
1523:
1422:
1408:
1308:
1293:LibmanâSacks endocarditis
1262:
1248:
1164:
1113:
1106:
1043:
998:
955:
946:
842:
594:(18_suppl_3): S729âS767.
467:10.1016/j.cnc.2016.04.004
99:
51:
46:
37:
29:
24:
2013:Medical aspects of death
1698:Ventricular fibrillation
969:Coronary artery aneurysm
699:Survey of Anesthesiology
362:Ventricular fibrillation
305:internal cardiac massage
217:
162:ventricular fibrillation
1975:Diastolic heart failure
1949:Athletic heart syndrome
1910:Ventricular hypertrophy
1644:Pre-excitation syndrome
1498:Left posterior fascicle
1023:Acute coronary syndrome
963:Coronary artery disease
436:A GreekâEnglish Lexicon
186:Asystole is treated by
169:ventricular tachycardia
124:(New Latin, from Greek
1493:Left anterior fascicle
1273:infective endocarditis
1058:Hibernating myocardium
939:Cardiovascular disease
1657:WolffâParkinsonâWhite
1617:Premature contraction
1515:AdamsâStokes syndrome
1218:Loeffler endocarditis
1028:Myocardial infarction
427:Liddell, Henry George
289:myocardial infarction
1824:Right axis deviation
1786:Sudden cardiac death
1144:Pericardial effusion
1087:Ventricular aneurysm
280:Tension pneumothorax
2018:Medical emergencies
1829:Left axis deviation
1686:Atrial fibrillation
1681:Ventricular flutter
1604:Torsades de pointes
1478:Bundle branch block
1437:Sick sinus syndrome
1223:Cardiac amyloidosis
1208:Tachycardia-induced
1063:Myocardial stunning
1011:Prinzmetal's angina
980:Coronary thrombosis
506:10.1503/cmaj.100034
374:Agonal heart rhythm
181:high blood pressure
177:intensive care unit
2028:Cardiac arrhythmia
1932:Atrial enlargement
1730:Pacemaker syndrome
1652:LownâGanongâLevine
1574:Junctional ectopic
1569:AV nodal reentrant
1075:Myocardial rupture
985:Coronary vasospasm
293:pulmonary embolism
142:general anesthesia
138:heart-lung machine
2000:
1999:
1992:Obstructive shock
1896:
1895:
1843:Short QT syndrome
1810:Other / ungrouped
1801:Sinoatrial arrest
1716:Ectopic pacemaker
1612:
1611:
1432:Sinus bradycardia
1404:
1403:
1400:
1399:
1149:Cardiac tamponade
1102:
1101:
1092:Dressler syndrome
990:Myocardial bridge
905:
904:
768:978-0-87493-424-3
735:978-0-87493-341-3
500:(14): 1589â1595.
398:Harper, Douglas.
275:Cardiac tamponade
128:"not, without" +
119:
118:
19:Medical condition
2035:
1965:Cardiac fibrosis
1857:T wave alternans
1750:Long QT syndrome
1544:Supraventricular
1540:
1539:
1473:Intraventricular
1420:
1419:
1260:
1259:
1111:
1110:
956:Coronary disease
953:
952:
932:
925:
918:
909:
908:
840:
839:
828:
827:
815:
809:
808:
779:
773:
772:
756:
746:
740:
739:
724:Mazur G (2004).
721:
715:
714:
694:
688:
687:
677:
660:(9): 1261â1266.
645:
639:
638:
620:
614:
613:
603:
578:
572:
571:
534:
528:
527:
517:
485:
479:
478:
450:
444:
423:
422:
416:
410:
409:
395:
359:
347:
335:
150:cardiac flatline
134:heart arrhythmia
115:
114:
91:
90:
87:
86:
83:
80:
77:
74:
71:
68:
65:
42:
22:
21:
2043:
2042:
2038:
2037:
2036:
2034:
2033:
2032:
2023:Causes of death
2003:
2002:
2001:
1996:
1987:Rheumatic fever
1953:
1892:
1805:
1772:
1744:
1702:
1661:
1638:
1608:
1580:
1527:
1519:
1413:
1396:
1304:
1253:
1244:
1160:
1154:Hemopericardium
1098:
1039:
1033:Unstable angina
1006:Angina pectoris
999:Active ischemia
994:
942:
936:
906:
901:
900:
851:
837:
832:
831:
816:
812:
780:
776:
769:
747:
743:
736:
722:
718:
696:
695:
691:
646:
642:
621:
617:
579:
575:
535:
531:
486:
482:
451:
447:
441:Perseus Project
417:
413:
396:
392:
387:
370:
363:
360:
351:
348:
339:
336:
318:, resulting in
220:
109:
95:
62:
58:
20:
17:
12:
11:
5:
2041:
2031:
2030:
2025:
2020:
2015:
1998:
1997:
1995:
1994:
1989:
1984:
1983:
1982:
1980:Cardiac asthma
1977:
1967:
1961:
1959:
1955:
1954:
1952:
1951:
1946:
1945:
1944:
1939:
1929:
1928:
1927:
1922:
1917:
1906:
1904:
1898:
1897:
1894:
1893:
1891:
1890:
1888:Strain pattern
1885:
1884:
1883:
1878:
1873:
1861:
1860:
1859:
1847:
1846:
1845:
1833:
1832:
1831:
1826:
1813:
1811:
1807:
1806:
1804:
1803:
1798:
1793:
1788:
1782:
1780:
1778:Cardiac arrest
1774:
1773:
1771:
1770:
1765:
1760:
1758:AndersenâTawil
1754:
1752:
1746:
1745:
1743:
1742:
1737:
1732:
1727:
1722:
1712:
1710:
1704:
1703:
1701:
1700:
1695:
1694:
1693:
1683:
1678:
1676:Atrial flutter
1672:
1670:
1663:
1662:
1660:
1659:
1654:
1648:
1646:
1640:
1639:
1637:
1636:
1631:
1626:
1620:
1618:
1614:
1613:
1610:
1609:
1607:
1606:
1601:
1596:
1590:
1588:
1582:
1581:
1579:
1578:
1577:
1576:
1571:
1561:
1560:
1559:
1548:
1546:
1537:
1521:
1520:
1518:
1517:
1512:
1511:
1510:
1505:
1500:
1495:
1490:
1485:
1475:
1470:
1469:
1468:
1463:
1458:
1448:
1439:
1434:
1428:
1426:
1417:
1406:
1405:
1402:
1401:
1398:
1397:
1395:
1394:
1393:
1392:
1387:
1375:
1374:
1373:
1368:
1356:
1355:
1354:
1349:
1337:
1336:
1335:
1330:
1325:
1312:
1310:
1306:
1305:
1303:
1302:
1301:
1300:
1295:
1283:
1282:
1281:
1268:
1266:
1257:
1246:
1245:
1243:
1242:
1237:
1236:
1235:
1230:
1225:
1220:
1215:
1210:
1205:
1200:
1199:
1198:
1186:Cardiomyopathy
1183:
1182:
1181:
1179:Chagas disease
1170:
1168:
1162:
1161:
1159:
1158:
1157:
1156:
1151:
1141:
1140:
1139:
1130:
1119:
1117:
1108:
1104:
1103:
1100:
1099:
1097:
1096:
1095:
1094:
1089:
1079:
1078:
1077:
1067:
1066:
1065:
1060:
1049:
1047:
1041:
1040:
1038:
1037:
1036:
1035:
1030:
1020:
1019:
1018:
1013:
1002:
1000:
996:
995:
993:
992:
987:
982:
977:
971:
966:
959:
957:
950:
944:
943:
935:
934:
927:
920:
912:
903:
902:
899:
898:
883:
868:
852:
847:
846:
844:
843:Classification
836:
835:External links
833:
830:
829:
810:
774:
767:
741:
734:
716:
689:
640:
615:
573:
546:(3): 511â517.
529:
480:
461:(3): 317â329.
445:
411:
389:
388:
386:
383:
382:
381:
379:Ictal asystole
376:
369:
366:
365:
364:
361:
354:
352:
349:
342:
340:
337:
330:
297:
296:
282:
277:
272:
262:
253:
248:
238:
233:
219:
216:
173:defibrillation
146:cardiac arrest
117:
116:
103:
97:
96:
94:
93:
55:
53:
49:
48:
44:
43:
35:
34:
31:
27:
26:
18:
15:
9:
6:
4:
3:
2:
2040:
2029:
2026:
2024:
2021:
2019:
2016:
2014:
2011:
2010:
2008:
1993:
1990:
1988:
1985:
1981:
1978:
1976:
1973:
1972:
1971:
1970:Heart failure
1968:
1966:
1963:
1962:
1960:
1956:
1950:
1947:
1943:
1940:
1938:
1935:
1934:
1933:
1930:
1926:
1923:
1921:
1918:
1916:
1913:
1912:
1911:
1908:
1907:
1905:
1903:
1899:
1889:
1886:
1882:
1881:ST depression
1879:
1877:
1874:
1872:
1869:
1868:
1867:
1866:
1862:
1858:
1855:
1854:
1853:
1852:
1848:
1844:
1841:
1840:
1839:
1838:
1834:
1830:
1827:
1825:
1822:
1821:
1820:
1819:
1815:
1814:
1812:
1808:
1802:
1799:
1797:
1794:
1792:
1789:
1787:
1784:
1783:
1781:
1779:
1775:
1769:
1766:
1764:
1761:
1759:
1756:
1755:
1753:
1751:
1747:
1741:
1738:
1736:
1733:
1731:
1728:
1726:
1723:
1721:
1717:
1714:
1713:
1711:
1709:
1705:
1699:
1696:
1692:
1689:
1688:
1687:
1684:
1682:
1679:
1677:
1674:
1673:
1671:
1669:
1664:
1658:
1655:
1653:
1650:
1649:
1647:
1645:
1641:
1635:
1632:
1630:
1627:
1625:
1622:
1621:
1619:
1615:
1605:
1602:
1600:
1597:
1595:
1592:
1591:
1589:
1587:
1583:
1575:
1572:
1570:
1567:
1566:
1565:
1562:
1558:
1555:
1554:
1553:
1550:
1549:
1547:
1545:
1541:
1538:
1535:
1531:
1526:
1522:
1516:
1513:
1509:
1508:Trifascicular
1506:
1504:
1501:
1499:
1496:
1494:
1491:
1489:
1486:
1484:
1481:
1480:
1479:
1476:
1474:
1471:
1467:
1464:
1462:
1459:
1457:
1454:
1453:
1452:
1449:
1447:
1443:
1440:
1438:
1435:
1433:
1430:
1429:
1427:
1425:
1421:
1418:
1416:
1411:
1407:
1391:
1390:regurgitation
1388:
1386:
1383:
1382:
1381:
1380:
1376:
1372:
1371:regurgitation
1369:
1367:
1364:
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1902:Cardiomegaly
1876:ST elevation
1863:
1849:
1835:
1816:
1790:
1720:Ectopic beat
1668:fibrillation
1503:Bifascicular
1377:
1358:
1339:
1315:
1285:
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1264:Endocarditis
1203:Hypertrophic
1137:Constrictive
1123:Pericarditis
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256:Hyperkalemia
221:
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204:hypokalaemia
185:
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158:
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129:
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120:
1768:RomanoâWard
1735:Parasystole
1634:Ventricular
1586:Ventricular
1525:Tachycardia
1442:Heart block
1424:Bradycardia
1250:Endocardium
1213:Restrictive
1174:Myocarditis
1115:Pericardium
785:Circulation
588:Circulation
320:brain death
260:hypokalemia
251:Hypothermia
231:Hypovolemia
196:epinephrine
192:vasopressor
126:privative a
30:Other names
2007:Categories
1666:Flutter /
1629:Junctional
1564:Junctional
1557:Multifocal
1530:paroxysmal
1446:Sinoatrial
1415:arrhythmia
1410:Conduction
1166:Myocardium
400:"asystole"
385:References
285:Thrombosis
106:Cardiology
1925:Pulmonary
1708:Pacemaker
1379:pulmonary
1360:tricuspid
1196:Alcoholic
824:eMedicine
224:Hs and Ts
200:Hs and Ts
101:Specialty
1791:Asystole
1691:Familial
1385:stenosis
1366:stenosis
1347:stenosis
1328:stenosis
1323:prolapse
1045:Sequelae
948:Ischemia
805:16314375
684:23454257
635:28613616
626:Asystole
610:20956224
568:58580872
560:30658877
524:21844108
475:27484660
368:See also
350:Asystole
245:acidosis
241:Hydrogen
208:atropine
194:such as
122:Asystole
25:Asystole
1191:Dilated
1133:Chronic
941:(heart)
675:3947599
515:3185075
439:at the
421:ĎĎ
ĎĎοΝΎ
313:hypoxic
236:Hypoxia
130:systolÄ
1871:J wave
1624:Atrial
1552:Atrial
1341:aortic
1317:mitral
1309:Valves
1255:valves
1107:Layers
976:(SCAD)
866:MC82.2
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267:(e.g.
265:Toxins
243:ions (
108:
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1958:Other
1942:Right
1920:Right
1534:sinus
1483:Right
1233:Viral
1128:Acute
1082:weeks
1053:hours
965:(CAD)
896:427.5
881:I46.0
564:S2CID
218:Cause
154:heart
1937:Left
1915:Left
1532:and
1488:Left
1070:days
891:9-CM
801:PMID
763:ISBN
730:ISBN
680:PMID
631:PMID
606:PMID
556:PMID
520:PMID
471:PMID
309:dead
140:and
887:ICD
872:ICD
857:ICD
793:doi
789:112
759:3â5
707:doi
670:PMC
662:doi
596:doi
592:122
548:doi
510:PMC
502:doi
498:183
463:doi
322:or
303:or
301:CPR
291:or
258:or
2009::
1865:ST
1837:QT
1718:/
1466:3°
1461:2°
1456:1°
1451:AV
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88:/
79:t
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73:ÉŞ
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67:Ë
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61:/
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