Ventricular fibrillation

Description

Ventricular fibrillation is a type of irregular heart rhythm (arrhythmia). During ventricular fibrillation, the bottom of the chambers of the heart contract in a very rapid and uncoordinated manner. As a result, the heart does not pump blood to the rest of the body.

Ventricular fibrillation is a medical emergency that requires immediate medical attention. It is the most frequent cause of sudden cardiac death.

Emergency treatment for ventricular fibrillation includes cardiopulmonary resuscitation (CPR) and shock in the heart with a device called an automated external defibrillator (AED). Medications, implanted devices or surgery may be recommended to prevent episodes of ventricular fibrillation.

Ventricular fibrillation can also be called VFib, V-fib or VF.

Symptoms

Collapse and loss of consciousness are the most common symptoms of ventricular fibrillation.

Prior to an episode of ventricular fibrillation, can have symptoms of an irregular shape, or fast or irregular heartbeat (arrhythmia). You can have:

  • Pain in the chest
  • Very fast heartbeat (tachycardia).
  • Dizziness
  • Nausea
  • Shortness of breath

When to see a doctor

Make an appointment with the heart doctor (cardiologist) if you have a loss of fast or pounding heartbeat.

If you see someone collapse, seek emergency medical help immediately. Follow these steps:

  • Call 911 or the local emergency number.
  • If the person is unconscious, check for a pulse.
  • If there is no pulse, begin cardiopulmonary resuscitation (CPR) to help keep the blood flowing through the body until an automated external defibrillator (AED) is available. The American Heart Association recommends hands-only CPR . Push hard and fast on the chest of the person — about 100 to 120 times per minute. It is not necessary to check the airways or deliver breaths of rescue. Continue until emergency medical help arrives.
  • The use of an automated external defibrillator (AED) as soon as it is available. To deliver a shock by following the prompts on the device.

Causes

Ventricular fibrillation is caused by:

  • A problem in the heart's electrical properties
  • A disruption of the blood supply to the heart muscle

Sometimes, the cause of ventricular fibrillation is unknown.

To understand more about how to ventricular fibrillation occurs, it can be useful to know how the heart normally beats.

The beat of the heart

The typical heart has four chambers: two upper chambers (atria) and two lower chambers (ventricles). Within the right upper chamber of the heart (the right atrium) is a group of cells called the sinus node. The sinoatrial node is the natural pacemaker of the heart. Produces the signals start of each beat of the heart.

These electrical signals move through the atria, causing the muscles of the heart to contract and pump blood into the ventricles.

Next, the signals that arrive at a group of cells called the atrioventricular (AV) node, where they slow down. This slight delay allows the ventricles to fill with blood. When the signals reach the ventricles, the lower chambers of the heart to contract and pump blood to the lungs or to the rest of the body.

In a typical heart, this heart signaling process usually goes well, resulting in a typical resting heart rate is 60 to 100 beats per minute. But in ventricular fibrillation, rapid, irregular electrical signals cause the lower chambers of the heart to quiver uselessly instead of pumping blood.

Risk factors

Things that may increase the risk of ventricular fibrillation are:

  • A previous episode of ventricular fibrillation
  • A previous heart attack.
  • A problem of the heart that are present at birth (congenital heart defect)
  • Heart muscle disease (cardiomyopathy)
  • The injuries that cause damage to the heart muscle, such as being struck by lightning
  • Drug abuse, especially cocaine or methamphetamine
  • A strong imbalance of potassium or magnesium

Complications

Without immediate treatment, ventricular fibrillation can cause death in a matter of minutes. The condition of rapid, erratic heartbeats cause the heart to suddenly stop pumping blood to the body. Blood pressure drops suddenly and significantly. The longer the body lacks blood, the greater the risk of damage to the brain and other organs.

Ventricular fibrillation is the most frequent cause of sudden cardiac death. The risk of other complications in the long term depends on how quickly treatment is received.

Ventricular fibrillation

Diagnosis

Ventricular fibrillation is always diagnosed in an emergency situation. If sudden cardiac death has occurred, a pulse check will not disclose pulse.

Tests to diagnose and determine the cause of the ventricular fibrillation are:

  • Electrocardiogram (ECG or EKG). This quick and painless test that measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. The wires connect the electrodes to a computer, which displays the results of the test. An electrocardiogram (ECG) may show whether the heart is beating too fast or too slow. If you are having an episode of ventricular fibrillation, the ECG usually shows a heartbeat of around 300 to 400 beats per minute.
  • Blood tests. Blood tests may be performed to check the proteins (enzymes) that leak into the bloodstream when the heart is damaged by a heart attack.
  • X-ray of the chest. An X-ray image of the chest can show the size and shape of the heart and its blood vessels.
  • The echocardiogram. This non-invasive test that uses sound waves to create images of the heart in motion. It can display the heart's size and structure.
  • Coronary catheterization (angiogram). This test helps healthcare providers see the blockages in the arteries of the heart. A long, thin, flexible tube (catheter) that is inserted into a blood vessel, usually in the groin or the wrist, and guided to the heart. Contrast dye flows through the catheter into the arteries in the heart. The dye helps the arteries to show up more clearly on X-ray images and video.
  • Cardiac computed tomography (CT). A computed tomography (CT) scan uses X-rays to create cross-sectional images of specific parts of your body.
  • Cardiac magnetic resonance imaging (MRI). This test uses a magnetic field and computer-generated radio waves to create detailed images of blood flow in the heart.

Treatment

Ventricular fibrillation requires emergency medical treatment to prevent sudden cardiac death. The goal of emergency treatment is to restore the flow of blood as soon as possible to avoid organ and brain damage.

Emergency treatment for ventricular fibrillation includes:

  • Cardiopulmonary resuscitation (CPR). cardiopulmonary resuscitation (CPR) mimics the motion of the heart's pumping. It keeps the flow of blood through the body. First, call 911 or the local emergency number. Then, start cpr by pushing hard and fast on the chest of the person — about 100 to 120 compressions per minute. Let the chest rise completely between compressions. Continue CPR until an automated external defibrillator (AED) is available, or emergency medical help arrives.
  • Defibrillation. This treatment is also called cardioversion. An automated external defibrillator (AED) provides shock through the chest wall to the heart. It can help to restore a regular heart rhythm. As soon as an automated external defibrillator (AED) is available, application, and follow the instructions. If you're not trained to use an aed , a 911 operator or other emergency medical operator may be able to give instructions. Audience and use of automated external defibrillators (Aeds) are programmed to recognize ventricular fibrillation and send a shock only when necessary.

Other treatments for ventricular fibrillation are to prevent future episodes and to reduce the risk of arrhythmia-related symptoms. The treatment for ventricular fibrillation includes medicines, medical devices and surgery.

Drugs

Medicines to control the rhythm of the heart, the anti-arrhythmic medications) are used for emergency or long-term treatment of ventricular fibrillation. If you are at risk of ventricular fibrillation or sudden cardiac death, your doctor may prescribe medications to reduce and control the beating of your heart.

Surgery or other procedures

Surgery or medical procedures for the treatment of ventricular fibrillation are:

  • An Implantable cardioverter defibrillator (ICD). An implantable cardioverter defibrillator (ICD) is a battery of the unit that is implanted under the skin near the collarbone — similar to a pacemaker. The ICD continuously monitors the heart rhythm. If the device detects an episode of ventricular fibrillation, it sends downloads to stop it and reset the heart's rhythm.
  • Cardiac ablation. This procedure uses heat or cold energy to create small scars on the heart block irregular heart signals that cause ventricular fibrillation. It is most often makes use of thin, flexible tubes called catheters are inserted through the veins or arteries. Also can be done during heart surgery.
  • Coronary angioplasty and stent placement.If ventricular fibrillation is caused by a heart attack, this procedure can reduce the risk of future episodes of ventricular fibrillation. The doctor inserts a long, thin tube (catheter) through an artery, usually in the groin, to a blocked artery in the heart. A balloon at the tip of the catheter is briefly inflated to widen the artery. This restores the flow of blood to the heart. A metal mesh stent may be placed in the artery to help it stay open.
  • Coronary bypass surgery. This open-heart surgery redirects blood around a section of a blocked or partially blocked artery in the heart. You can do it if ventricular fibrillation is caused by disease of the coronary artery. During bypass surgery, the surgeon takes a healthy blood vessel from your leg, arm or chest. It is connected above and below the blockage of the artery or arteries in the heart. This creates a new pathway for the flow of blood.

Coronary angioplasty and stent placement. If ventricular fibrillation is caused by a heart attack, this procedure can reduce the risk of future episodes of ventricular fibrillation.

The doctor inserts a long, thin tube (catheter) through an artery, usually in the groin, to a blocked artery in the heart. A balloon at the tip of the catheter is briefly inflated to widen the artery. This restores the flow of blood to the heart. A metal mesh stent may be placed in the artery to help it stay open.

Self-care

Lifestyle changes that help keep the heart healthy as possible include the following:

  • Eat a healthy diet. Heart-healthy foods include fruits, vegetables, and whole grains, as well as lean sources of protein such as soy, beans, nuts, fish, skinless chicken and low-fat dairy products. Avoid adding salt (sodium), added sugars and saturated fats.
  • Exercise. Physical activity helps to achieve and maintain a healthy weight. Regular exercise helps to control diabetes, high cholesterol, and high blood pressure — all risk factors for heart disease. With your provider to ACCEPT, the goal is 30 to 60 minutes of physical activity most days of the week. Talk with your health care provider about the amount and type of exercise is best for you.
  • Control the weight. Being overweight increases your risk of heart disease. Talk with your healthcare provider to set realistic goals for body mass index (BMI) and weight.
  • Do not smoke. Smoking is a major risk factor for heart disease, especially atherosclerosis. Quitting smoking is the best way of reducing the risk of heart disease and its complications. If you need help to stop smoking, talk with your provider.
  • Manage blood pressure and cholesterol. Get health checkups to monitor the blood pressure and cholesterol. Take medications as prescribed to treat high blood pressure or high cholesterol.
  • Limit the consumption of alcohol. Too much alcohol can damage the heart. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Get regular check-ups. Take your medications as prescribed. Have regular follow-up appointments with your health care provider. Tell your doctor if your symptoms get worse.
  • Practice good sleep habits. Lack of sleep can increase the risk of heart disease and other chronic conditions. Adults should aim to get 7 to 9 hours of sleep daily. Children often need more. Go to bed and wake up at the same time every day, including weekends. If you have trouble sleeping, talk with your provider about strategies that might help.

Coping and support

Some of the irregular heart rhythms (arrhythmias) can be triggered by emotional stress. Take steps to alleviate the stress and anxiety can help keep the heart healthy. Do more exercise, the practice of mindfulness and connecting with others in support groups are some of the ways to reduce and manage stress. If you have anxiety or depression, talk with your provider about strategies to help.

Some types of complementary and alternative therapies can help to reduce stress, such as:

  • Yoga
  • Meditation
  • Relaxation techniques or mindfulness

Get the support of the loved ones that may also be useful.

Symptoms and treatment of Ventricular fibrillation