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What Causes Asystole?

Asystole is a condition in which the heart has no electrical activity and thus does not contract and pumps no blood. You may hear it referred to as a flatline on a heart monitor. Resuscitation is rare; only about 2 percent of patients survive. Asystole occurs about equally across races. Women are less likely to have the underlying conditions, but if they do have them they are more likely to experience asystole.

  1. Primary Asystole

    • Primary asystole occurs when your heart cells no longer perform their metabolic processes (the reactions that allow the cells to live). When those processes stop, your heart can no longer create an electric impulse. Several things might cause this, including a congenital defect that leads to a heart blockage; ischemia (reduced blood flow); infarctions (blocked arteries) and heart attacks; or being struck by lightning.

    Secondary Asystole

    • Secondary asystole is a result of some problem outside the heart itself. Oxygen deprivation from suffocation or near drowning can result in secondary asystole. Strokes and embolisms also may be involved. Other possible causes include hyperkalemia (excess potassium) and overdoses from sedatives or narcotics.

    Special Circumstances

    • Hypothermia--extreme loss of body heat--can result in asystole, without any underlying physiological problem. It slows your body down, decreasing proper metabolic function. Hypothermia-induced asystole will kill you if left untreated for too long, but you are more likely to survive overall because your body can tolerate the condition for a longer time.

    Immediate Treatment

    • Treatment for asystole varies according to its cause. Medical professionals usually avoid defibrillation because the electric shock may cause more damage. However, if the cause is non-metabolic such as a heart attack, defibrillation may work. An injection of epinephrine (a type of adrenaline), vasopressin or atropine may be applied as well.

    Follow Up Treatment

    • Those who survive asystole will need additional care. Inpatient treatments may include cooling the body. Post-treatment complications might include fractured ribs, internal cuts and embolisms. Prevention is difficult but may be possible with the use of a pacemaker.

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