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{{quote|''[[Hell Is That Noise|Beep... beep... beep...beep...]]''
'''''[[Oh Crap|BEEEEEEE]][[Tear Jerker|EEEEEEEP!]]''''' }}
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The technical term for a "flatline" is asystole ("a-" for lacking, "systole" for the contraction cycle of a heartbeat). This event is not always the result of the character having a heart condition; asystole can be caused by lots of things, including profound hypoxia (lack of oxygen in the blood), poisonings and intoxications, and consequences of trauma (i.e. massive hemorrhage, tension pneumothorax - leaking air from a collapsed lung putting pressure on the heart, or cardiac tamponade - blood building up around the heart and squeezing it to death). However, the circumstances leading to asystole are always catastrophic in nature, such that even if you manage to re-establish a rhythm (itself usually a losing proposition), the patient's chances of actual recovery are abysmal.
Regardless of what they were hospitalized for, if a character is hooked up to a cardiac monitor, they will almost always flatline at some point. Additionally it will either be an instant thing from a regular heartbeat to a line, or a very sudden series of erratic bleeps suggesting the patient is having a heart-attack, often from stress, just before the flatline itself. If the scene is being played for comedy, the "flatline" may be the result of the patient playing with the monitor leads, getting up for a bathroom trip, a guest accidentally tripping over the monitor, or other such mundane causes.
[[Rule of Perception]] says that a flatline on film is always... well, a flat line. However, in [[Real Life]] a recently asystolic patient would still show occasional waves on the screen, a condition also known as Pulseless Electrical Activity - the electrical signal to beat is being generated, but the heart muscle isn't responding anymore.
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* Pretty much every show set in a hospital has done this, if not hundreds of times, then at least dozens. Though the best ones usually avert [[Magical Defibrillator]].
** ''[[ER]]'', being set in an emergency room, might be the record-holder, because sometimes this occurs three or four times ''per episode''.
*** Done in a very odd way during the credits of the last [[St. Elsewhere]] episode. The MTM cat was shown lying still, flanked by a beeping heart monitor and IV bag. As the theme music ended, the monitor went to flatline instead of the kitty's traditional "Meow!" Yes, the autistic kid killed a kitty...
* ''[[Dallas]]'': The seventh-season ending, where Bobby Ewing dies; this is ''not'' the "shower scene" cliffhanger that aired a year later, but the episode where Bobby was struck by a car and mortally injured. As usually seems to be the case for "he's gonna die" episodes, the entire cast gathers at the victim's bedside (in this case, Bobby's) as the soon-to-be-deceased mumbles a few last words to family and loved ones; in this case, Bobby's last muttered words are, "I love you" before the flatline. Unintentionally comes off as being [[Played for Laughs]] because of the cheesy setup, the lack of emotion shown by a fake teary-eyed Larry Hagman, and the foregone conclusion that Bobby was going to die (due to Patrick Duffy leaving the show due to conflicts with the show's producers and writers—until he got them resolved a year later ... ).
* Subverted in an episode of ''[[One Foot in the Grave]]''. Margaret is hooked up to life support as Victor stays with her, holding her hand. The heart monitor does the standard "beep.. beep.. beep.. beep.. beeeeeeeeeeeeeeeep", and prompts a [[Really Dead Montage]] from Victor, and then a nurse wanders by, complains that the heart monitor had been faulty all week, [[Percussive Maintenance|bashes it]], and apologises, as it starts beeping regularly again.
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'''Alpha:''' Huh. When did ''you'' die? }}
* ''[[The Good Guys]]'' subverts this in the pilot episode. A plastic surgeon is operating on a criminal when a flatline occurs. The surgeon tells the guy's goons that it is probably just a loose wire but they do not believe him and pull out their guns. The doctor panics and the goons open fire, hit some oxygen bottles and blow themselves up. It really was just a loose wire.
* Subverted on on ''[[Chuck]]''. In a season four episode, an attacker assaults someone who is gravely wounded in the hospital, and smiles when he sees the monitor flatline. Of course, the "victim" had merely unplugged his fingertip pulse-oximeter.
* Used for comedy in one episode of [[Home Improvement (TV series)|Home Improvement]], Tim Allen takes applies 2 nodes to his chest, beep.....beep.....beep. He starts breathing heavily and tries again, beep..beep..beep..beep. He then puts the nodes on his head to which it flat-lines.
* Hospital scenes in Soap Operas seem fond of this trope. The setup is formulatic: The soon-to-be-departing cast member either is suffering from the final stages of an illness or is so severely hurt in an accident that the injuries cannot be healed and he/she is going to die, the character's family (or, especially if the character is a totally hot babe, just her boyfriend) gathers at bedside, the doomed character and several others share some tearful last words, and the flatline occurs, with rare attempts made by the doctors to resusitate the character.
* {{spoiler|Gentaro}} at the end of episode 31 of ''[[Kamen Rider Fourze]]''. He wasn't hooked to any machine, but there was a line on the screen meant to invoke this.
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* The opening of Nexus' [http://www.youtube.com/watch?v=G0wHJSqodmQ Return from Flatliner] features a [[Heartbeat Soundtrack]] followed by this.
* Xorcist's [http://www.youtube.com/watch?v=FH7zbjX14hw "Crack"] opens with a flatlining EKG; by the dialogue, a drug user apparently is having a [[Near-Death Experience]] after doing it the first time. "I didn't do that much stuff, it's only the first time! Oh God please, I wanna go back! "Oh please God, I wanna live!"
* The long, sustained G note during the song "My Iron Lung" by Radiohead sounds like a (take wild guess) a flat EKG. Considering the sardonic tone of the song, it's open to interpretation whether it means a person has died, or Radiohead is comparing their success as "dead"
* ''Experiment Four'', Mr. 76ix's latest album, ends with this, and the last track is appropriately titled "Mors Janua Vitae".
== [[Professional Wrestling]] ==
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** It also occurs every time you die in the first game.
** The flatline for the players death seems to be the HEV suit's monitoring system while the combine soldiers seems more like radio feedback.
* The ancient PC game ''[[Weird Dreams]]'' used this trope. The premise of the game was that the weird scenarios were literally a dying dream. The player character was actually in Intensive Care. If the player lost the game, he died. Highlighted by a graphic of a heart monitor's beep stuttering while it briefly flatlined if the player lost a life. Lose the last life and it stayed flatlined.
* Part of the sound effects in the ''[[Dance Dance Revolution]]'' track "Healing Vision", the "plot" being that the person is having a near death experience. The flatline is much more obvious in "Healing Vision: Angelic Mix"; in that version, the EKG's even rhythm devolves into chaotic fibrillation for about three or four measures before flatlining. The arrow targets stop momentarily to highlight the steady sound, which persists through the rest of the song until the final two beats (inverting [[Last-Note Nightmare]] nicely).
* In ''[[The Journeyman Project]]'', a flatline tone is played upon Game Over.
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* In the ''[[Invader Zim]]'' episode "Bad, Bad Rubber Piggy," Zim is keeping track of Dib's vital signs as he sends objects into the past to try and kill him—after sustaining multiple injuries, he finally flatlines after Zim replaces the paramedic's defilibrator with rubber pigs. [[Roaring Rampage of Revenge|Unfortunately for Zim]], he gets better.
* Played for laughs (yes, this is possible with this trope) in ''[[Courage the Cowardly Dog]]''. Courage has a heart attack during a [[Wild Take]] in one episode. When he's recovering in Dr. Vindaloo's office, he grabs the doctor and runs off. The leads on his EKG snap off and it goes to flatline.
* In an episode of [[King of the Hill]], Hank's father Cotton is able to cause a flatline at will using a trick he learned in the military. He does this several times in the episode, so when he actually does die everyone's a little unsure.
* Subverted in ''[[Action League NOW]]'': "Danger for a Dignitary". After The Flesh accidentally gets an ambassador injured, Bill the Lab Guy is forced to do a delicate procedure to fix him:
{{quote|'''Bill the Lab Guy:''' Nurse Thunder, I need more glue. (*flatline*) Oh no, I've lost him! I was afraid of this!
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{{reflist}}
[[Category:Death Tropes]]
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