Profound Vagal Tone and Bradycardia Mimicking Asystole: A Resuscitation Case Report

Profound Vagal Tone and Bradycardia Mimicking Asystole: A Resuscitation Case Report

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A 48-year-old man presented with dizziness.When he arrived at the emergency department, he collapsed and became pulseless.Prior to his collapse, he was asymptomatic and now even participated in multiple D-GLUCOSAMINE marathon and ultra-running events per year.However, he previously experienced a vasospastic inferior STEMI eight years prior from copyright use.

As a result, he had an ischaemic cardiomyopathy with LVEF of 45%.He never took any further illicit substances after the STEMI; instead, he changed his lifestyle completely and commenced extreme endurance sports.After one hour of alternations between VF/VT rhythms and asystole, a rhythm check demonstrated a single complex with a corresponding pulse.He had received 12 Roll On mg of epinephrine up to that point as per local resuscitation guidelines.

Upon diagnosing extreme bradycardia, 2 mg of total atropine administration resulted in ROSC.We theorise that this bradycardia was a result of increased vagal tone as ROSC was quickly achieved following atropine administration.