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  • Title: Atrial fibrillation with high degree atrioventricular block masquerading as ventricular fibrillation masquerading as asystole during cardiac arrest.
    Author: Ornato JP, Gonzales ER, Garnett R.
    Journal: Crit Care Med; 1987 Apr; 15(4):334-5. PubMed ID: 3545680.
    Abstract:
    Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block. AF with a high degree block can masquerade as VF, which simultaneously masquerades as asystole, and can be correctly diagnosed by bedside intracardiac monitoring. Patients who have a flat line rhythm which may represent asystole, fine ventricular fibrillation, or atrial fibrillation with a high degree atrioventricular block may warrant a trial of electrical countershock, high-dose atropine, or transthoracic pacing.
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