Ventricular Fibrillation

  • Definition

    The ventricles are the large lower chamber 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 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.
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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.
    The following factors increase your chance of developing ventricular fibrillation. If you have any of these risk factors, tell your doctor:
  • 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 electrocardiography (ECG) . 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 re-establish 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.
    Defibrillation should be done as soon as equipment is available.
    Anti-arrhythmic Drugs
    Anti-arrhythmic drugs, such as amiodarone , lidocaine , and procainamide , 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
    Nucleus Image
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    If you are diagnosed with ventricular fibrillation, follow your doctor's instructions .
  • Prevention

    To help reduce your chance of getting ventricular fibrillation, take the following steps:
    • 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, lose weight.
      • Don’t smoke. If you smoke, 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. He 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

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca

    National Stroke and Heart Foundation of Canada http://www.heartandstroke.com

    References

    ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation. 2006;114:e385.

    American Heart Association. A new order for CPR, spelled C-A-B. American Heart Association website. Available at: http://www.newsroom.heart.org/index.php?s=43&item=1139. Published October 18, 2010. October 21, 2010.

    Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy. 17th ed. Hoboken, NJ: John Wiley and Sons, Inc.; 1999.

    Braunwald E, Zipes DP, Libby P. Heart Disease: A Textbook of Cardiovascular Disease. 6th ed. Philadelphia, PA: WB Saunders Company; 2001.

    Cardiopulmonary resuscitation (CPR). American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4479. Accessed August 7, 2005.

    Defibrillation. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4540. Accessed August 7, 2005.

    Marx JA. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, MO: Mosby, Inc.; 2002.

    Rakel RE. Textbook of Family Practice. 6th ed. Philadelphia, PA: WB Saunders Company; 2002.

    Risk factors and prevention. Heart Rhythm Society website. Available at: http://hrspatients.org/patients/risk%5Ffactors/default.asp. Accessed August 7, 2005.

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