Ventricular Fibrillation

Definition

The ventricles are the large lower chambers of the heart. They are responsible for moving blood to the organs and tissues of the body. In ventricular fibrillation, the heart’s ventricles contract in a rapid and chaotic manner. As a result, little or no blood is pumped from the heart. Unless emergency medical help is provided immediately, ventricular fibrillation will lead to cardiovascular collapse and sudden death.

Blood Flow Through Heart

blood flow heart
Ventricles are lower area of red and blue sections
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Causes

Causes of ventricular fibrillation include:

Risk Factors

Ventricular fibrillation is most commonly associated with CAD. Factors that can increase risk of CAD will also increase the risk of ventricular fibrillation. These include:

Symptoms

Ventricular fibrillation happens without warning. When it occurs, symptoms may include:

  • Loss of consciousness within seconds
  • Sudden collapse
  • Seizures
  • Loss of color in the skin
  • Dilated pupils
  • No detectable pulse, heartbeat, or blood pressure

Diagnosis

Ventricular fibrillation is suspected when a person collapses suddenly and has no detectable pulse or heartbeat. The diagnosis is confirmed by ECG. An ECG records the heart’s activity by measuring electrical currents through the heart muscle.

Treatment

Ventricular fibrillation must be treated as an extreme emergency and treatment must be administered within 4-6 minutes.

Cardiopulmonary Resuscitation (CPR)

CPR, which begins with giving chest compressions, is a temporary procedure that can help maintain some blood flow to the brain, heart, and other vital organs until trained medical personnel are available to provide more advanced treatment.

Defibrillation

In defibrillation, an electronic device is used to give an electric shock to the heart. The electric shock helps to reestablish the normal contraction rhythms of the heart. An automated external defibrillator (AED) is a portable defibrillation device. Most ambulances carry AEDs. They are also frequently found in many public places, such as sports complexes and restaurants.

Defibrillation should be done as soon as equipment is available.

Anti-arrhythmic Drugs

Anti-arrhythmic drugs may be given intravenously with continued resuscitation attempts when a person continues to fibrillate.

If the heart’s rhythm is stabilized by defibrillation, anti-arrhythmic drugs can be given to maintain the heart’s rhythm.

Implantable Cardioverter Defibrillator

An implantable cardioverter defibrillator (ICD) can be surgically placed in the chest to help prevent ventricular fibrillation. An ICD continuously monitors the heart’s rhythm. If it detects an abnormal beat, it automatically sends electrical impulses to restore the heart’s normal rhythm.

Implanted Cardioverter Defibrillator

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Prevention

To help reduce your chances of ventricular fibrillation:

  • Lower your risk of CAD:
    • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
    • Exercise regularly.
    • If you are overweight, talk to your doctor about how to lose weight safely.
    • If you smoke, talk to your doctor about how to successfully quit.
  • Avoid or limit your intake of caffeine, alcohol, and other substances that may contribute to arrhythmias or heart disease.
  • Avoid unnecessary stress, and try to manage or control stressful situations that cannot be avoided.
  • If you have a family history of this condition, see your doctor. A doctor can evaluate your risk.

If a person is at high risk of ventricular fibrillation, an implantable cardioverter defibrillator (ICD) can be surgically placed in the chest to help stop ventricular fibrillation. In addition, anti-arrhythmic drugs may be given to try to prevent a future episode.

RESOURCES:

American Heart Association
http://www.heart.org/
Heart Rhythm Society
http://www.hrsonline.org/

CANADIAN RESOURCES:

Canadian Heart Rhythm Society
http://www.chrsonline.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References:

ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation. 2006;114(10):e385-e484.
CPR and first aid. American Heart Association website. Available at:
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Risk factors & prevention. Heart Rhythm Society website. Available at:
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Ventricular fibrillation (VF). Merck Manual Professional Version. Available at:
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What is an automatic external defibrillator? American Heart Association website. Available at:
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Last reviewed November 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 12/20/2020

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