Heart Escape Rhythm & Asystole

Escape Rhythms

by IAN MC - 2018-05-24 09:43:19

I'm no expert but I think that the answer to all four questions is " Possibly, but not necessarily "

All electrical problems of the heart , whether we are talking about lazy sinus nodes or  varying degrees of AV block may be INTERMITTENT  in nature .   So in the good periods, normal natural heart pacemaker activity may kick in.  You cannot assume that escape rhythms are always involved.

You had asystole so had no discernible electrical activity of the heart and then something kicked in to help rectify the problem ; I guess you will never know what that " something  " was. It may have been an escape rhythm , it may not.

But at the end of the day, whatever the electrical faults are which have caused  our bradycardia  and cardiac pauses ,  the fact remains that we need pacemakers... we are where we are !

Cheers

Ian

Heart Escape Rhythm & Asystole

by 3degree - 2018-05-24 10:17:19

Hi Ian Thanks for the very useful helpful comments

Luckily? I have a copy of two ECG's taken just after the Asystole both showing a vent rate of 32bpm along with other information eg PR interval, QRS duration, QT/QTc, P-R-T axes that I assume shows an escape rhythm. St Thomas were reluctant to give me a copy showing the Asystole.(I had a heart stop of some sort again when the pacemaker was fitted during emergency theatre.)

How may this effect answers to my original 4 Questions?

Thanks in advance

My guesses.

by AgentX86 - 2018-05-24 22:18:56

1. Escape rhythm started heart?  My guess is "probably not".  The slowest escape rhythm is 20-40, from the ventricles.  Three or four seconds would tell me that it's an escape rhythm, not 12-seconds (<5bpm).

2.  Insecure rhythm?  Any asystole is "insecure", IMO. 

3. Pacemaker dependent with no underlying escape?  That would be my interpretation.

4. Would have had a cardiac arrest?  No, not "would have".  Did.

BTW, I'm right there with you, brother.  I pulled over 8-seconds before my AV ablation.  When they tested the PM, the tech commented that I had no underlying escape (which totally escaped my wife - she would have freaked). 

These are questions you should be asking your EP.

Heart Escape Rhythm & Asystole

by 3degree - 2018-05-25 05:41:21

AgentX86 Thank for your very useful comments I am getting ever closer to understanding and accepting what happened to me Thanks.

Cardiac arrest - what does it feel like?
My experience of the Asystole I had
I felt the blood draining from insde my head & down through my brain - mirrored,I felt, with my body. As if the nerves in my brain were directly connected to my body & limbs - which of course they are.(If you turned a large plastic bottle of milk upside down and let the milk glug out along with the movement being felt like an alternating pulsing electric current - thats what it felt like!) Then I went unconscious and when I came to was rushed for emergency pacemaker insertion.
Was this a cardiac arrest? I think so.

A cardiac arrest is when your heart suddenly stops pumping blood round your body, commonly because of a problem with electrical signals in your heart.
When your heart stops pumping blood, your brain is starved of oxygen. This causes you to fall unconscious and stop breathing.

Any comments welcome Thanks

PM Dependent

by NiceNiecey - 2018-05-26 02:07:35

Hello 3Degree.

I am not experienced enough or intelligent enough to directly answer your 4 questions.  I am, however, PM dependent.  

I started out like you: Mobitz Type 2 Heartblock.  Got a PM.  Within the first year, I had progressed to Complete Heartblock or 3rd Degree Heartblock.

During my check-ups, either my cardiologist or the device clinic nurses, drop my PM from a minimum of 60 BPM to 30 BPM (the nurses claim that's as low as they're allowed to drop it).  Because I do not have an escape rhythm at 30 BPM, I am classified as PM Dependent.  

I have learned "at the Club" that I might still have an escape rhythm that could kick in below the 30 BPM testing threshhold.  But then again, I may not.  When they drop my BPM to 30, I am immediately swooning and ready to black out.

I am thankful everyday for the gift of life that my PM has provided me.  Obviously, I would not be alive without it.  Sounds like that's the case with you, too.  Whew!

Niecey

Heart Escape Rhythm & Asystole

by 3degree - 2018-05-26 09:45:16

Thanks Niecey for your comments

I am also checked for an escape rhythm at 30 bpm after they first ask permission to do it - I do not feel anything, then they always ask me to cough to get the heart going again? or to get it in sync?

I hope your coping ok X Alan