Wikipedia notes that the technical term for flatline is asystole and adds this comment:

Despite defibrillation commonly appearing on medical dramas as a remedy for asystole, it is usually not done when there is a total absence of electrical activity, as it could actually make it more difficult to restart the heart.

The article on defibrillation makes a similar comment:

Similarly, medical providers are often depicted defibrillating patients with a "flat-line" ECG rhythm (also known as asystole); this is not done in real life as the heart is not restarted by the defibrillator itself.

Neither of these two claims are referenced. Searching quickly, I find plenty of references that defibrillators are not usable on flatlined patients but none of them appear to be authoritative. Pop culture apparently thinks it does work; the internet considers it a myth. Which is it?

  • 3
    de fibrillators are used to stop fibrillation an erratic heart rhythm caused by a rapid and unsynchronized firing of either the ventricles (ventricular fibrillation) or the atria (atrial fibrillation). Ventricular fibrillation is particularly dangerous because it all but stops the proper flow of oxygenated blood through the body. Both are medical emergencies. Personal Story - In High School a team mate of mine died during practice because his heart went into unprovoked fibrillation and a defibrillator wasn't used in time. – crasic Jul 4 '11 at 19:07
  • @MrHen The claims most likely aren’t especially referenced because they directly follow from how defibrillation works (see @crasic’s comment). That said, it is conceivable and apparently plausible that the electrical impulse of the defibrillator could “jump-start” the cardiomyocytes by generating an electric impulse. This doesn’t work, though, since the cells are depolarised and electric impulse has nothing to work on. – Konrad Rudolph Jul 5 '11 at 9:00

@crastic makes a good point that your heart has to be fibrillating to be defibrillated. Here is a link to the American Heart Association (AHA) which explains Ventricular Fibrillation (unsynchronized pumping). Defibrillation delivers a shock to the heart which should (hopefully) restart the normal cardiac rhythm.

Although I couldn't find anything that specifically address actually trying to defibrillate a flatlining person, this article (PDF) notes that out of hospital cardiac events can sometimes only be reversed with a defibrillator, and the chance of survival decreases by 7-10% for each minute of delay.

This article from the AHA indicates that an asystolic rhythm is non-shockable:

Shockable/nonshockable rhythm refers to the first monitored rhythm, which when analyzed by the person interpreting the monitor/defibrillator or an AED, was found to be treatable by attempted defibrillation (ie, shockable or nonshockable). In general, shockable cardiac arrest rhythms are further divided into ventricular fibrillation and pulseless ventricular tachycardia. Nonshockable cardiac arrest rhythms can be categorized as either asystole or PEA.

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