What is Agonal Rhythm?
The word “Agonal” refers to several medical problems that are connected to death, including agonal respiration, the “agonal state” (the physical condition of the body right before death), and agonal rhythm. Agonal rhythm is a slow heartbeat that occurs near death. Agonal rhythms come from the lower chambers of the heart (ventricles), and they are excessively slow and unpredictable. This severe arrhythmia occurs when the upper chambers of the heart cease to function.
This dysrhythmia poses a serious risk to the patient’s life. The agonal rhythm is the last organized heart electrical activity before death. The heart rate is below 20 beats per minute, there are no P waves, and the QRS complex is wide and unusual.
Agonal Rhythm Symptoms
A feeble pulse or no pulse, loss of consciousness, and agonal breathing, which is an irregular and frequently insufficient pattern of breathing that sounds like snorting, gasping, or labored breathing, are all symptoms of an agonal rhythm. Agonal breathing is sometimes accompanied by muscle twitching. An EKG showing the telltale signs of an agonal rhythm includes:
No P waves: It indicates that the heart’s top chambers aren’t beating.
Wide QRS complexes: This primarily indicates that the heart is contracting at a somewhat delayed rate compared to normal.
Agonal Rhythm Causes
The agonal heart rhythm is the result of severe harm to the muscles of the heart. Potential examples are:
- Cardiac Tamponade.
- Cardiac trauma, such as being stabbed or suffering a severe fall.
- Ventricular fibrillation.
Cardiac arrest can also result from the following additional conditions:
- Overdose of the drug.
- Suffocation or strangulation.
- TBI, or traumatic brain injury.
- Carbon monoxide poisoning.
Agonal Rhythm ECG
An agonal rhythm, which is an unusually slow and unpredictable pulse coming from the bottom chambers of the heart (ventricles), is often confirmed by an electrocardiogram (ECG), which is frequently the last sign of organized electrical activity in the heart before death. The ECG reading of agonal rhythm reveals the absence of P waves, indicating that the upper chambers of the heart are not beating, and wide QRS complexes, which typically have a broad and bizarre morphology.
Agonal rhythm is typically so slow that a single six-second rhythm strip cannot establish whether it is regular or irregular. At least three complexes on the trace are needed to make this determination. Agonal heart rhythms are mainly ventricular and have occasional P waves and QRS complexes on the ECG.
Agonal Rhythm Treatment
In the clinical setting, an agonal rhythm is evaluated in the same manner as asystole and needs to be treated in the same manner with cardiopulmonary resuscitation, or CPR. The heart does not pump blood to the body’s organs during an agonal heart rhythm, depriving them of oxygen. This particular form of arrhythmia is the final type of cardiac rhythm that takes place before a person enters asystole, which is the state in which all electrical activity in the heart ceases and a person passes away. A person who is going through an agonal rhythm is not going to be able to feel pain, and they are going to probably pass out from lack of oxygen. It is possible to comfort loved ones even if they are unconscious.
Agonal Rhythm vs Pea
There are a few distinct varieties of cardiac arrest, the most common of which are the agonal rhythm and the pulseless electrical activity (PEA). Agonal rhythm is an extremely slow and erratic heartbeat that comes from the heart’s lower chambers (ventricles). It is often the last sign of organized electrical activity in the heart before death. PEA, on the other hand, is a sort of irregular heart rhythm that happens without a pulse and is caused by a malfunction of the heart’s electrical circuitry. CPR is used to treat agonal rhythm like how asystole is treated. On the other hand, PEA requires both CPR and addressing the underlying causes of cardiac arrest.