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Asystole 101 question
Posted by susan.d
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Asystole 101 question January 25, 2024 02:27PM |
Registered: 10 years ago Posts: 2,515 |
I’m watching an episode of the good doctor and tge patient was Asystole . I am curious about the meaning so I googled it.
Asystole is when your heart’s electrical system fails, causing your heart to stop pumping. This is also known as “flat-line” or “flat-lining” because it causes your heart’s electrical activity to look like a flat line on an electrocardiogram. Without immediate CPR or medical care, this condition is deadly within minutes.
Can someone who has a pacemaker flatline? If a patient with a
Pacemaker still pace after their death?
The series is as good as google. I’m going a lot of pausing and googling.
Curious if anyone has an answer.
Asystole is when your heart’s electrical system fails, causing your heart to stop pumping. This is also known as “flat-line” or “flat-lining” because it causes your heart’s electrical activity to look like a flat line on an electrocardiogram. Without immediate CPR or medical care, this condition is deadly within minutes.
Can someone who has a pacemaker flatline? If a patient with a
Pacemaker still pace after their death?
The series is as good as google. I’m going a lot of pausing and googling.
Curious if anyone has an answer.
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Re: Asystole 101 question January 25, 2024 04:50PM |
Registered: 11 years ago Posts: 4,222 |
Here is ChatGPT 4's answer:
I provided the same prompt, but asked it to provide references. Here is the response:
This was a suggested search reference: [www.bing.com]
Quote
Yes, a person with a pacemaker can still go into asystole. Asystole refers to a state where there is no electrical activity in the heart, leading to a flatline on an electrocardiogram (ECG). Pacemakers are designed to regulate the heart's rhythm by sending electrical impulses to stimulate the heart to beat when it's not beating correctly or regularly. However, they cannot reverse asystole.
Asystole can occur even in individuals with pacemakers for several reasons:
Pacemaker Malfunction: If the pacemaker fails to work correctly, due to issues like battery depletion, lead displacement, or electronic failure, it might not provide the necessary stimulation to keep the heart beating.
Underlying Cardiac Conditions: Patients with severe underlying heart conditions may progress to asystole despite the presence of a pacemaker. The pacemaker can only do so much to manage heart rhythms and cannot reverse severe cardiac damage or disease.
External Factors: Certain external factors, such as extreme electrolyte imbalances, severe hypoxia, or drug overdoses, might lead to asystole, regardless of pacemaker function.
End-of-Life Heart Failure: In some cases, particularly with terminal illnesses, the heart may naturally progress to asystole as part of the dying process.
It's important for individuals with a pacemaker to have regular check-ups to ensure that their device is functioning properly and to manage any underlying cardiac conditions they may have.
I provided the same prompt, but asked it to provide references. Here is the response:
Quote
Yes, a person with a pacemaker can still experience asystole. A pacemaker is a device implanted to regulate a slow heart rate by sending electrical impulses to the heart. It's used for conditions like sinus node disease, heart block, and other issues causing a slower-than-normal heart rate. However, it primarily functions to correct bradycardia (slow heart rate) and may not be effective in preventing or correcting asystole, which is a complete cessation of heart electrical activity.
Asystole can still occur in patients with pacemakers. In some cases, the heart may skip several beats in a row, leading to asystole. The pacemaker's role is to send electrical impulses to stimulate the heart when it does not beat correctly. However, if the heart's natural pacemaker (the sinus node) sends an electrical impulse but the heart does not respond (as in ventricular fibrillation or ventricular tachycardia), the pacemaker may not intervene immediately, leading to a temporary asystolic event. The pacemaker constantly monitors the heart's rhythm and will send an impulse if it detects a lack of natural impulses from the heart's pacemaker. However, this process is not instantaneous and may result in brief periods of asystole. Furthermore, pacemakers are not designed to respond to all types of cardiac events and may not be able to prevent or correct every instance of asystole.
Regular monitoring and maintenance of the pacemaker are crucial to ensure its optimal functioning. Patients with pacemakers should maintain regular check-ups and follow their healthcare provider's guidance regarding the management of their heart condition.
This was a suggested search reference: [www.bing.com]
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Re: Asystole 101 question January 25, 2024 05:01PM |
Registered: 10 years ago Posts: 2,515 |
If my PM is “tickling “ 7 volts each beat plus 30 second burst theory each time it’s parameter settings are met, plus routine downloads, multiple that by its appropriate 12 battery lifespan, how can the battery possibly last so long?
Ok one volt equals one joule. If one’s PM is set to 60 beats per minute (not including appropriate 150 burst therapy lasting up to 30 seconds each arrhythmia or tachycardia) then one is getting 1440 joules every 24 hours (times 365.24 days a year) =525,945.6 joules a year. Multiply by the average battery lifespan of 12 years = 6,311,347.2 joules… Add extra for each pacemaker interrogation one gets typically 4/year which I am told is very battery depleting…plus the number of burst therapy sessions lasting up to 30 seconds each one.
That’s a lot of joules for a tiny battery.
Got curious and looked it up — Not enough joules really to run an appliance.
[www.s-ehrlich.com]
Edited 2 time(s). Last edit at 01/25/2024 05:26PM by susan.d.
Ok one volt equals one joule. If one’s PM is set to 60 beats per minute (not including appropriate 150 burst therapy lasting up to 30 seconds each arrhythmia or tachycardia) then one is getting 1440 joules every 24 hours (times 365.24 days a year) =525,945.6 joules a year. Multiply by the average battery lifespan of 12 years = 6,311,347.2 joules… Add extra for each pacemaker interrogation one gets typically 4/year which I am told is very battery depleting…plus the number of burst therapy sessions lasting up to 30 seconds each one.
That’s a lot of joules for a tiny battery.
Got curious and looked it up — Not enough joules really to run an appliance.
[www.s-ehrlich.com]
Edited 2 time(s). Last edit at 01/25/2024 05:26PM by susan.d.
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Re: Asystole 101 question January 25, 2024 06:54PM |
Admin Registered: 6 years ago Posts: 5,343 |
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Re: Asystole 101 question January 25, 2024 11:10PM |
Registered: 1 year ago Posts: 9 |
One Joule does not equal 1 volt. 1 Volt = 1Joule/coulomb and a Coulomb is a large charge. I think your intuition is correct that the battery likely doesn't have that amount of energy, so your PM doesn't need that much current (Coulombs/sec). PM energy requirement is ~ 15 microJoules for each pulse, I believe.
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Re: Asystole 101 question January 26, 2024 03:38AM |
Registered: 10 years ago Posts: 2,515 |
Quote
mike111
One Joule does not equal 1 volt. 1 Volt = 1Joule/coulomb and a Coulomb is a large charge. I think your intuition is correct that the battery likely doesn't have that amount of energy, so your PM doesn't need that much current (Coulombs/sec). PM energy requirement is ~ 15 microJoules for each pulse, I believe.
I used the following site when calculating volts to joules:
[online-learning-college.com].)
Thank you Carey. I had showed you my ekg the morning after my ablation when my heart stopped 15 seconds. To this day I don’t understand why nurses didn’t run into my hospital room to defib me or at least walk over for observation. My ekg showed Asystole. I was discharged and returned that week when it repeated every 5-10 minutes for two days until I got a pacemaker. It’s reassuring my PM will control my heart not to flatline.
Curious question then. How can a doctor ever declare death to his patients who have pacemakers? Brain death determination?
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Re: Asystole 101 question January 26, 2024 09:48AM |
Admin Registered: 6 years ago Posts: 5,343 |
Contrary to what Hollywood would have you believe, asystole isn't shockable. That's why no one raced to shock you.
There are two stages of death: clinical death and biological death. Clinical death is the absence of a pulse. When that happens, CPR should be initiated under almost all circumstances. Defibrillation should occur if the patient is in a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia). But clinical death doesn't mean there's no hope. Prompt CPR, drugs, oxygen and especially defibrillation (when appropriate) might restore a pulse and prevent biological death. But if it doesn't, cells in the body begin to die, and this can be measured by measuring how much carbon dioxide the body is still producing. Living cells produce CO2, dead cells don't. CO2 can be measured easily with a cheap, simple device known as a capnometer that gets attached to the endotracheal tube that's down the patient's throat. When the capnometer says the patient is no longer exhaling CO2, biological death has occurred and there is no hope of return.
The fact that you have a pacemaker ticking away will never influence a doctor's or paramedic's decision to terminate resuscitation. The presence of a pulse and the presence of CO2 being exhaled will make that decision. If a pulse is restored but the patient doesn't regain consciousness, then brain death becomes the deciding factor and that generally takes a day or two to determine.
There are two stages of death: clinical death and biological death. Clinical death is the absence of a pulse. When that happens, CPR should be initiated under almost all circumstances. Defibrillation should occur if the patient is in a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia). But clinical death doesn't mean there's no hope. Prompt CPR, drugs, oxygen and especially defibrillation (when appropriate) might restore a pulse and prevent biological death. But if it doesn't, cells in the body begin to die, and this can be measured by measuring how much carbon dioxide the body is still producing. Living cells produce CO2, dead cells don't. CO2 can be measured easily with a cheap, simple device known as a capnometer that gets attached to the endotracheal tube that's down the patient's throat. When the capnometer says the patient is no longer exhaling CO2, biological death has occurred and there is no hope of return.
The fact that you have a pacemaker ticking away will never influence a doctor's or paramedic's decision to terminate resuscitation. The presence of a pulse and the presence of CO2 being exhaled will make that decision. If a pulse is restored but the patient doesn't regain consciousness, then brain death becomes the deciding factor and that generally takes a day or two to determine.
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