P wave Asystole

Hi All,

I was wondering if anyone has experience of P wave Asystole,

I have recently received pacemaker due to heart block and my discharge 

notes say that I was having P wave Asystole episodes.

i would like to know if anyone has had same condition and how 

pacemaker has helped,my hope is that I will be able to soon be

back to my old self (if possible)

thanks in anticipation 



P-wave asystole

by AgentX86 - 2020-03-12 13:30:07

This is not good. Essentially, your SI node is still pumping out P-waves and the atria are happy as claims but nothing is getting through to the ventricles. Nothing. No junctional rhythm, no escape rhythm. Nothing. Needless to say, this will cause syncope or even SCA. It's considered more dangerous than Vfib.

ask your doctor

by Tracey_E - 2020-03-12 18:57:53

Your doctor is the only one who can tell you for sure what it means. I've learned over the years that there are a whole lot of terms for the same thing, and that frequently our ekg's are misread if we are outside of a cardiologist's office where they are used to reading our charts so all sorts of random (and inaccurate) things end up in our charts. Don't panic, just call your doctor's office and have your questions written down. First thing I would ask is how often and how long were the episodes. There's a big difference between tons of episodes and one or two that lasted a few seconds. Next ask if the pacer has fixed it. If they thought you were at risk of SCA, they would have given you an ICD, not a regular pacer. 


by AgentX86 - 2020-03-12 22:07:14

This isn't necessarily true. A "P-wave asystole" is a very particular and fairly rare electrical problem that a pacemaker fixes completely. It's essentially complete, complete heart block with no escape rhythm. Since it's not a complete lack of electrical activity, rather a disconnect between the atria an ventricles (with no ventricular escape rhythm), an ICD isn't necessary.

Sure, ask your EP about any problems. That's the best source of information but apparently the message didn't make it across. You can learn the right questions to ask here.

P wave asystole

by Louise71 - 2020-07-17 08:09:32

Hi. After being told I had heart block as the reason for my pm the cardiologist I had my 7 week check up this week and whom I interrogated advised That was a basic explanation and that I actually have p wave asystole.  He told me that basically my sinus node forgets to beat and that my heart stops beating for 5/6 seconds, which in the average adult with a heartbeat of 85bpm, means that in 5 seconds my heart misses 7 beats which is why I was getting very light headed.  

My pacemaker is set at 60bpm which has helped although I have the occasional episode of lightheadedness .  I have a transmitter at home and he was able to review all the data while on the phone and apparently last week there was an unscheduled download because my heart was beating at 180bpm for 14 seconds so went the total opposite way.  I have been told to keep a note about any episodes I have in case bc a stern arises and I can css as ok them and also if I get pains in my chest for more than 5 or 10 mins I bc should go in.

Not sure this is helpful but I only had my pm implanted in May so still learning myself.


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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.