Asystole?

[Mom2four85]

I was reading in the new expert heart rhythm forum a post about exercise http://www.medhelp.org/forums/Heart-Rhythm/show/91 and read the doctor's response but I'm alittle confused about something.  

"Sudden cardiac death usually results from malignant VT, VF or rarely asystole"  I thought VF/Asystole were the same?

What is asystole and what role does it play in malignant arrhythmia's? I know I have malignant arrhythmia's and polymorphic VT.  My new ICD report shows "During ablation patient had VF arrest + Asystole" so what's the difference if any between my P-VT runs going into VFib and asystole?

I didn't think anything about it until I read this from the doctor and haven't seen this together before my reports.

[Mom2four85]

I found this in an article on Emedicine: "Asystole is a state of no cardiac electrical activity, hence no contractions of the myocardium and no cardiac output or blood flow. Asystole or bradyasystole follows untreated VF and commonly occurs after unsuccessful attempts at defibrillation.  Resuscitation is rare; only about 2 percent of patients survive".

I posted about this in my journal since my dr mentioned my worsening neurologic and cognitive problems this year.

"Complications from asystole include permanent neurologic impairment and complications from cardiopulmonary resuscitation (CPR) or invasive procedures".

I question which came first VF arrest or asystole but not sure how to find that answer.  I looked at asystole causes and the only thing that jumped out at me was hypothyroidism but mine isn't that bad <5.0...what I wouldn't give for a video or script of the procedure.

[Mom2four85]

In August 2009 I went in for an EP Study & ablation for pvc's/vt.  During the ablation the dr triggered long sustained runs of polymorphic VT that stopped my heart 3 times.

I had no structural heart problems before; just fainting, dizziness, headaches and tons of different arrhythmia's since I was 9.  After ablation, I had testing done to see what was going on (long story it's in my journals) and was dx with HOCM and an PM/ICD implanted due to my lifelong bradycardia and arrhythmia's.

I know my EP said the first time my heart stopped I flat lined, they shocked me and at count 0 they were going to shock me again; but then my heart started.  He went to 2 other sites and I had to be hit once more but the 3rd time my heart started on it's own.

I had 3 Vtach episodes a few months ago and in the reports from the ER I got it had "during ablation patient had VF Arrest & Asystole".  

First time I had read that since it wasn't in any hospital or dr reports and I'm curious to find out if that's the case; just no way to know.

[justanumber]

you can't shock asystole..all you can do is give drugs and do chest compressions. what happened to you..heart attack?

[Mom2four85]

I've read quite a bit on asystole now; seems weird that the protocol is to give epinephrine every 3-5 minutes yet they shocked me with 360j instead of giving me it

this really makes me wonder what happened because I remember him telling me my heart stopped and I flat lined the first time he hit the spot in the bottom thin underside of the heart.

unless epi is administered you don't survive asystole - maybe my life is just a dream?!

[bbxx]

ooooh, did you have to mention sinus pause, or heart block.
too much info is not good.....
but seriously is_something you are brilliant

[Mom2four85]

that's why I'm confused; why wouldn't the EP Study show this?

now I'm really curious what caused it and was the asystole the reason my heart stopped the first time and the dfib didn't work so they were going to shock me again.

interesting thing though...ahhh more research and questions now lol

[is_something_wrong]

If you went from P-VT, to fibrillation and then asystole, you probably wouldn't be sitting here now.....

Asystole usually occur after sustained fibrillation, when the heart isn't able to produce electrical impulses anymore, and the rhythm is usually not shockable (because the shocks actually produce a short asystole, that's the point with shocking). Sounds like you had asystole a short time from some other cause, but impossible for me to say..

[Mom2four85]

Thanks for the explanation I knew you or Itdood would know what it meant.  

That's what I thought from reading but didn't understand it fully; I think I'm even more confused now and no way to ask the EP I had.

I know he told me I didn't respond to the first shock they gave me and at count 0 they were getting ready to shock me again; then my heart started.  

So I went into sustained P-VT; fibrillation then asystole if I understand this correctly?  How the heck do you come back from asystole then if they don't give you adrenaline? No where in the reports does it say they gave me anything just used the paddles to shock me.

sorry I'm just having a really hard time understanding this - maybe his reports are leaving something out or I'm not understanding the report?

[is_something_wrong]

Hi!

Asystole is what's known as "flatline" where there are no electrical activity in the heart. Asystole is the most dangerous "arrhythmia" as it's not shockable, so the only thing doctors can do is to give massive amounts of adrenaline and hope the asystole will change into sinus rhythm or some kind of shockable rhythm (fibrillation or tachycardia).

For a defibrillator to work, there must be electrical activity in the heart. With fibrillation, there are lots of activity, actually too much. This is quickly exhausting the heart as there are no blood supply to feed the heart the necessary nutrition to maintain activity. After a couple of minutes, the rhythm turns into "fine" fibrillation, and a couple of minutes later, asystole. That's why time is critical during CPR.

Another (far more benign) form of asystole is temporary asystole, like sinus arrest, pauses after A-fib, heart block, etc.