Ventricular fibrillation (VF) is considered the most serious cardiac arrhythmias. Disordered electrical activity causes the ventricles to quiver (or fibrillate) instead of contracting normally. This prevents the heart from pumping blood, causing collapse and cardiac arrest. Show
VF has been identified in nearly 70% of cardiac arrest patients. Without treatment, the condition is fatal within minutes. The rates of survival for VF patients outside the hospitals have increased slightly however many are left with residual anoxic brain damage and neurological deficits. The cause of ventricular fibrillation is not always known but it can occur during certain medical conditions. VF most commonly occurs during an acute heart attack or shortly thereafter. The root causes include: Coronary artery disease; Damage to the heart muscle from eg myocardial infarction; Cardiomyopathy; Electrolyte abnormalities (hypokalemia/hyperkalemia, hypomagnesemia); Acidosis; Hypothermia; Hypoxia; Alcohol use; Drug toxicity; Sepsis (severe body infection); Family history of sudden cardiac death. Automatic implantable cardioverter defibrillator. The total annual burden of Out of Hospital Cardiac Arrest (OHCA) was estimated at 356,500 in 2017 in America. At least 23% of OHCA treated by Emergency Medical Service have VF/VT as the initial rhythm. With more than 60% of cardiovascular deaths resulting from cardiac arrest, it remains the leading cause of death worldwide. Modern advances in assistive devices such as implantable cardioverter-defibrillator (ICD) have had a significant impact on these numbers. . Symptoms of VF include:
Normal ECG one wavelength Acute presentation of symptoms and ECG findings lead to the diagnosis. ECG Findings
Patients surviving VF should have a thorough history and physical examination. Including:
V-fib comes on quickly and needs prompt treatment. Steps involved: Less Frequent Action
Prognosis of VF depends on the time from onset to early intervention and defibrillation. Shorter delays are associated with survival rates as high as 50%. VF outside the hospital can be reversed, as today there are defibrillators available in many places. The success of reversal declines at a rate of 5-10% for every minute that is delayed. Unfortunately many develop residual neurological deficits because of anoxia. Full recovery is rare. The health professional team may advise cardiac rehabilitation following hospitalisation and stabilisation of condition. Cardiac rehabilitation is a complex, interprofessional intervention customized to Coronary artery disease (CAD); Myocardial infarctions. Ventricular fibrillation (sometimes called v-fib for short) is a malfunction of the heart’s normal pumping sequence. It is the most common deadly irregular heart rhythm (arrhythmia).
OverviewElectrocardiogram from a patient with ventricular fibrillation.What is ventricular fibrillation?Ventricular fibrillation (sometimes called v-fib for short) is an arrhythmia, a malfunction of the heart’s normal pumping sequence. It is the most common deadly arrhythmia. When it happens, the lower chambers of your heart quiver or twitch instead of completely expanding and squeezing. This means they aren’t pumping blood as they should. Why is ventricular fibrillation so dangerous?When blood stops flowing for this reason, you normally have just a few seconds before you pass out. This is called sudden cardiac arrest, which usually results in death in just a few minutes without immediate care. Sudden cardiac arrest is the No. 1 cause of natural death in the United States, and accounts for half of all deaths from heart disease. What are coarse ventricular fibrillation and fine ventricular fibrillation?Ventricular fibrillation on an electrocardiogram is a wave of peaks and valleys. How this wave appears tends to get grouped into two categories, coarse and fine.
Overall, coarse ventricular fibrillation is preferred because it is more strongly associated with survival and good outcomes. That’s because coarse fibrillation is closer to normal heart activity than fine ventricular fibrillation. What is refractory v-fib?Refractory ventricular fibrillation happens when ventricular fibrillation continues even after three successive shocks from a defibrillator. Ventricular fibrillation is considered difficult to treat, but research is ongoing on how to overcome this complication. Symptoms and CausesWhat causes v-fib?Ventricular fibrillation is most commonly caused by the following:
What are the symptoms of ventricular fibrillation?The following symptoms are common just before v-fib:
Someone who has this condition will collapse with little or no warning and won’t respond or react when you try to wake them. They’ll also gasp for breath or stop breathing altogether. Diagnosis and TestsWhat tests are done for ventricular fibrillation?Ventricular fibrillation is usually confirmed by an electrocardiogram (ECG or EKG), especially after a person has been resuscitated from cardiac arrest. This is also useful to determine the heart’s ability to function going forward. Management and TreatmentHow is v-fib treated?The condition is a life-threatening medical emergency and every minute counts. The following actions can help save the life of someone who has gone into sudden cardiac arrest because of ventricular fibrillation:
People who survive ventricular fibrillation have a higher risk of it happening again, so your healthcare provider will run tests to determine what caused it to happen and what follow-up options will work best to keep it from happening again.
Frequently Asked QuestionsWhat is the difference between atrial fibrillation (a-fib) and ventricular fibrillation?Atrial fibrillation is similar to ventricular fibrillation, but it’s happening in the upper chambers of the heart, called the atria. When the atria fibrillate, they beat very fast (sometimes several hundred times per minute). This can cause blood to collect in the atria and over time, this can cause the atria to stretch and enlarge. When blood collects in one place like this, it increases the risk of forming a clot, which can then go from the heart to the brain. This is why atrial fibrillation is not considered dangerous on its own, but is a major risk factor for stroke. Is v-fib the same as a heart attack?Ventricular fibrillation is a malfunction of the normal beating rhythm of the lower chambers of the heart. A heart attack is different because it is caused by blockages in the blood vessels that supply the heart with enough oxygen to keep pumping. However, a heart attack can cause ventricular fibrillation. What is the difference between ventricular tachycardia and ventricular fibrillation?Ventricular tachycardia and ventricular fibrillation are closely related, very similar conditions. The difference between the two is that in ventricular tachycardia, the lower chambers of the heart are beating much faster than they should but the overall process is happening in the right order. In ventricular fibrillation, the heart’s beating process isn’t happening in the right order. Both ventricular tachycardia and ventricular fibrillation are considered life-threatening because they can lead to collapse and sudden cardiac arrest. In emergencies, both are typically treated with defibrillation. Long-term, both are typically treated with a surgically placed implanted cardioverter defibrillator. A note from the Cleveland Clinic Ventricular fibrillation and sudden cardiac arrest can be difficult topics to discuss, especially for people who’ve experienced it before. Your healthcare provider can give you guidance that can help you better understand your condition. These resources can help you take care of yourself and focus on living your life. Share Email Print Last reviewed by a Cleveland Clinic medical professional on 09/20/2021. References
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What is the most important initial treatment for a patient in ventricular fibrillation?External electrical defibrillation remains the most successful treatment for ventricular fibrillation (VF). A shock is delivered to the heart to uniformly and simultaneously depolarize a critical mass of the excitable myocardium.
What are nursing interventions for ventricular fibrillation?Treatment includes:. CPR (cardiopulmonary resuscitation). The first response to V-fib may be CPR. ... . Defibrillation. This is an electrical shock that is delivered to your chest wall to restore normal rhythm. ... . Medicines. ... . Implantable cardioverter defibrillator (ICD). ... . Catheter ablation. ... . Left cardiac sympathetic denervation.. What is the first line treatment for ventricular tachycardia?Anti-arrhythmic medications are the first-line therapy in emergency departments and CCUs, as discussed earlier. Amiodarone is most commonly used, along with lidocaine, and in some cases procainamide.
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What is the most effective initial intervention for ventricular fibrillation?
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