brugada syndrome

defibrillation

ventricular arrhythmias

cardiac arrest ohca

automated external

out-of-hospital cardiac arrest

cardiac pacing

hospital discharge

ventricular fibrillation

American Journal of Physiology-heart and Circulatory Physiology

Editorial FocusRacing to the flatline: heart rate and β-adrenergic stimulation quicken the paceMatthew Kay, Sarah Kuzmiak-Glancy, and Jack RogersMatthew KayDepartment of Biomedical Engineering, The George Washington University, Washington, District of Columbia; and , Sarah Kuzmiak-GlancyDepartment of Biomedical Engineering, The George Washington University, Washington, District of Columbia; and , and Jack RogersDepartment of Biomedical Engineering, The University of Alabama at Birmingham, Department of Biomedical Engineering, Birmingham, AlabamaPublished Online:01 May 2015https://doi.org/10.1152/ajpheart.00154.2015This is the final version - click for previous versionMoreSectionsPDF (54 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat asystole, identified as a flatline in all ECG leads, is a nonshockable rhythm that is associated with high mortality. Patients with coronary artery disease who suffer a sudden occlusion may progress to asystole through a sequence of events initiated at the onset of the occlusion: local ischemia, ventricular tachycardia (VT), ventricular fibrillation (VF), global ischemia, and asystole. Defibrillation has the highest efficacy when applied during VF, well before asystole. Prognosis is dim for patients suffering from out-of-hospital cardiac arrest (OHCA) who are found in asystole. An analysis of the Swedish OHCA registry has shown that patients who were found in a nonshockable rhythm had an average one-month survival rate of 1.3% (8).Several retrospective studies have analyzed the incidence of lethal arrhythmias in OHCA and found that the incidence of arrest with VT/VF as the first recorded rhythm has steadily declined while the incidence of non-VF arrest, including asystole, has markedly increased (10, 13). The decline in VF arrest could be the result of reduced incidence of VT/VF as the cause of OHCA, likely because of increased use of implantable cardioverter defibrillators and β-blockers. Interestingly, th...

Racing to the flatline: heart rate and β-adrenergic stimulation quicken the pace