Agonal Rhythm

A fatal dysrhythmia with rates usually less than 20/minute and common widening of the QRS; also referred to as the dying heart.

Asystole is characterized by the absence of any waveforms. In reality, asystole is seldom a bone straight line until the patient has been without a pulse for some time. It is good practice to check lead integrity to ensure that the rhythm seen is not another case of disconnected leads. Progress through all of the leads available through your cardiac monitor. Also, increase the gain or size to ensure that fine electrical activity is not present.

In the process towards asystole, the occasional occurrence of grossly wide and progressively irregular QRS complexes forms an agonal rhythm. The presence of an agonal rhythm is as serious as asystole, prompting many health care practitioners to consider stopping any further attempts at resuscitation.

agonal, HR 8

1. Six Second ECG Guidebook (2012), T Barill, p. 121, 189

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