Which rhythm is seen just before the heart stops altogether, essentially asystole with occasional QRS complexes that do not produce cardiac output?

• A. Asystole
• B. Agonal Rhythm
• C. Ventricular Fibrillation
• D. Atrial Fibrillation

Answer: (B)

Agonal rhythm is a dying-heart rhythm. It features very slow, often irregular electrical activity, with only a few sporadic QRS complexes that fail to generate meaningful cardiac output. This pattern signals that the heart is near complete cessation and cannot sustain perfusion, even though you can momentarily see some electrical activity.

In contrast, true asystole shows no electrical activity at all (a flat line), so there are no QRS complexes to observe. Ventricular fibrillation presents as chaotic, disorganized electrical activity with no recognizable QRS, not occasional discrete beats. Atrial fibrillation is an irregular, typically faster rhythm with irregular intervals but not the near-death pattern of sparse, ineffective contractions seen in an agonal rhythm.