Can You Shock a Heart That Has Flatlined?
Does this commonly encountered scenario in Hollywood hold up under medical scrutiny?
Today, we are tackling a medical myth that is commonly perpetuated in popular culture that you can shock a heart out of asystole. We’ve all seen it. A dramatic movie scene in which a patient flatlines and the healthcare workers immediately move to pull out the defibrillator in a last-ditch effort to save a character’s life. It’s high stakes. It’s dramatic. It keeps you on the edge of your seat, teeming with anxiety. But it would never happen in real life.
The medical term for a flatline is “asystole,” meaning there are no heart contractions. Defibrillators are designed to produce an electrical shock in order to depolarize the cardiac system in an effort to restore a normal heart rhythm and can help in the case of “shockable rhythms” such as:
o Ventricular Fibrillation: This occurs when the ventricles, or lower chambers of the heart, begin quivering instead of pumping, preventing the heart from getting blood to the rest of the body. A “fine” v-fib may sometimes resemble asystole, but this is rare.
o Pulseless ventricular tachycardia: This occurs when the ventricles contract so quickly that blood cannot circulate to the rest of the body, leading to low blood pressure.
In the case of cardiac arrest (which may or may not include asystole), the recommended course of action is to begin chest compressions and administer adrenaline as soon as possible. In other words, while delivering a shock through the use of a defibrillator may help to stabilize certain types of arrhythmia, it cannot restore a nonexistent rhythm and would be useless in the case of a flatline. So the next time you hear that ominous sound on your television screen and watch the paramedics pull out the paddles while the physician shouts “clear,” you might find yourself exhaling in exasperation, but try not to let reality ruin the cinematic moment for you.
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