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The longest time that heart activity continued after restarting was 27 minutes, but most restarts lasted just one to two seconds. The longest that the heart stopped before restarting on its own was four minutes and 20 seconds. The paper described the review of 480 flatlines out of which 67 showed on-off fluctuations. There are some causes of a flat line that might not be an asystole such as loose leads, loss of power to the ECG monitor or low signal gain.Ī discussion paper published in a leading media journal talks about how the heart might continue to show electrical activity long after blood flow or pulse has stopped. I am sure many medical practitioners like me would often encounter such a tricky situation." In situations like these, you are in a war between the urge to confirm your objective observation and the human instinct to try once more. Also, the fact is not widely known that a flat-line on an ECG monitor offers a bleak possibility of coming back. When to stop is not an easy question to answer. I was objected to by the patient's family for not declaring him dead instantly and unnecessarily buying time but this slope is a slippery one. The doctor informed that the man had no previously known comorbidities and his was a case of unnatural death.ĭr Narayan said: "I tried to revive the man by giving him CPR and I did that for half an hour. A 57-year-old man was brought seemingly dead to the emergency room. The situation remains to be a shaky path and can have ethical and legal consequences for the practitioners.ĭr Sarath Narayan, an emergency physician practising in Sarvodaya Hospital, Faridabad shared a similar account. It might not be an easy task to declare a person dead without ensuring that their heartbeat and circulation might not return. The time how long a doctor has to wait after a 'flat-line' flashes on the monitor is a tricky span. More News Emergency physician shares a similar story

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There are other problematic rhythms that might mirror asystole in some circumstances, hence the doctors don't give up on the patient as soon as the flat line flashes on the screen and might engage in CPR (cardiopulmonary resuscitation) or shock therapy which might be necessary for other abnormal rhythms that can be rectified. Few patients are likely to have a positive clinical outcome in asystole as there are bleak chances of survival.

Sometimes the fault might be with the electrical machinery of the heart, other times it could be the muscular body that might give up.Īsystole is defined as a cardiac arrest rhythm in which there is no discernible electrical activity of the heart.

An abnormal ECG means that something might not be right with your heart. The graph that flashes on an ECG monitor taps the electrical activity of the heart. It is the minute current that forces your heart to pump blood throughout the body. As the attending doctor tries to confirm the flat line on the monitor, they have to ensure that the rhythm they are getting on the monitor is not mimicking the 'flat line' or what is technically called asystole. Many times, patients are brought seemingly dead to emergency rooms. As per medical experts, human heart activity is not an on-off switch but it can stop and restart multiple times during a critical cardiac event like an arrest. Interestingly, the classic flat line is not as straightforward as they might show in movies. Written by Kashish Sharma |Published : Febru6:45 PM ISTĮverybody understands a flat line on an ECG monitor and what it means.