I have seen 2 rhythm types on the natural course of dying (peacefully). In the first, the heart rate holds for a few hours (AF or sinus) then gradually declines and the latent pacemaker kick-in one-by-one (junctional to ventricle). The other one is the one I'll post here. So this is not the sudden cardiac death (SCD) where people get excited.
These are 5 strips (~ 4 minutes duration) captured in a DNR pt. Pt was in no distress during the whole process.
Pls note timestamp on the upper left part of the strip.
The rhythm is regular and narrow with ST changes.The latter part of the strip shows wide QRS rhythm most likely AIVR.
Few seconds later, it turned into a fast wide QRS rhythm (likely VT)
About 7 second later, change in morphology is seen (best seen in II, aVF and aVL)
About 2 minute later, looked like the QRS voltages becomes smaller and the rate becomes slower (agonal rhythm).
About 4 minutes after, asystole can be observed.