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Ventricular fibrillation masquerading as asystole.

Annals of Emergency Medicine

|September 1, 1984

Summary

This summary is machine-generated.

Ventricular fibrillation (VF) can appear as asystole on a single electrocardiogram (ECG) lead. Monitoring additional leads or changing paddle placement can reveal underlying VF, guiding appropriate defibrillation treatment.

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Area of Science:

Cardiology
Electrophysiology

Background:

True asystole and electromechanical dissociation are unresponsive to electrical shock.
Anecdotal reports suggest defibrillation can restore sinus rhythm in patients with apparent asystole.

Purpose of the Study:

To investigate the phenomenon of ventricular fibrillation (VF) masquerading as asystole.
To determine if VF exhibits a dominant electrical vector that can be missed with single-lead monitoring.

Main Methods:

21 dogs were induced into VF and monitored with standard 12-lead ECGs.
Analysis focused on identifying leads that showed no electrical activity (asystole) despite VF in other leads.

Main Results:

In two-thirds of dogs, one lead showed electrical asystole while VF was evident in all other leads.

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This indicates that VF can be misinterpreted as asystole when only a single ECG lead is monitored.

Conclusions:

Ventricular fibrillation may present as asystole if only one electrocardiogram (ECG) lead is monitored.
Clinicians should monitor additional leads or alter lead placement to rule out VF before withholding defibrillation for apparent asystole.