Ventricular Fibrillation - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Ventricular fibrillation, or VF, is a cardiovascular condition that results in a rapid and life-threatening rhythm of the heart that begins in the bottom chambers of the heart. The heart is divided into four chambers-two upper sections called the right atrium and left atrium, and two lower sections called the right ventricle and left ventricles. This abnormally fast rhythm may be triggered due to an episode of a heart attack.

Since the heart cannot pump an adequate amount of blood while suffering from ventricular fibrillation, sustained ventricular fibrillation may lead to a drastic drop in blood pressure or loss of consciousness, and even death. In addition, during the case of ventricular fibrillation, the heart signals get disorganized and disoriented. Therefore, V-fib or ventricular fibrillation is an emergency condition that demands immediate treatment and correction.

What Are the Causes of Ventricular Fibrillation?

The heart is sectioned into four chambers, and the upper two compartments are called the right and left atrium. The lower two compartments are called the right and left ventricles. The His-Purkinje System or the HPS or simply this His- is responsible for the prompt transmission of electrical impulses into the lower chambers of the heart, the ventricles. The AV node, or the atrioventricular node, is a tiny structure located in the heart. The chief function of this atrioventricular node is to control the flow of the heart’s electrical signals. Ventricular fibrillation is mainly caused due to a malfunctioning of the heart muscles, also called cardiac muscles, or the disruption in the electrical signals from the atrioventricular node or the His-Purkinje system. It should be noted that, at times, the cause of ventricular fibrillation remains unknown and undiagnosed.

Mentioned below are a few of the possible causes of ventricular fibrillation.

• Long-standing heart diseases that have not been treated or diagnosed.

• Episodes of a heart attack.

• Angina pectoris.

• Thickening of the walls of the hearts.

• Wearing down on thinning of the walls of the heart.

• Cardiac arrhythmias.

• Open heart surgery.

• Certain drugs and medications.

• Electrolyte imbalances in the body.

• Electrical shock to the body.

• An increased amount of potassium in the bloodstream.

• Abnormally low levels of potassium in the bloodstream.

• Being hit roughly in the chest.

• Being hit by a fast-moving object.

• Commotio cordis.

• Vigorous physical games such as hockey, baseball, and lacrosse.

• Cardiomyopathy.

• Acute heart attack.

• Long QT syndrome.

• Brugada disease.

• Hypertrophic cardiomyopathy.

• Short QT syndrome.

What Are the Signs and Symptoms of Ventricular Fibrillation?

Because there is no adequate blood supply during ventricular fibrillation, the blood pressure may drastically fluctuate and lead to several clinical manifestations. Mentioned below are a few of the signs and symptoms of ventricular fibrillation.

• Collapse.

• Episodes of dizziness.

• Fainting.

• Shortness of breath

• Cardiac arrest.

• Nausea.

• Palpitations.

• Tachycardia.

• Lightheadedness.

• Arrhythmia.

• Chest pain.

• Abnormal breathing pattern.

• No response on tapping on the shoulders.

• Loss of consciousness.

How Is Ventricular Fibrillation Diagnosed?

Ventricular fibrillation is generally diagnosed as an emergency condition. While checking the pulse of the patient, there will be no pulse in case sudden cardiac death has occurred.

Mentioned below are a few tests and diagnostic measures that may help in the diagnosis of ventricular fibrillation.

• An electrocardiogram or ECG or EKG is a quick and painless diagnostic test that measures the electrical activity of the heart.

• Blood tests are done to check for any enzymes that may have leaked into the bloodstream while the heart was damaged during a heart attack.

• A chest X-ray is an image of the chest that allows the healthcare professional to analyze the size and shape of the heart and cardiovascular blood vessels.

• An echocardiogram is a noninvasive test used to study sound waves in order to produce images of the heart's size and structure.

• Coronary catheterization or angiogram is a measure to determine if the coronary arteries are blocked.

• Cardiac computerized tomography or CT scan is an X-ray machine that rotates around the body and creates images of the heart and chest.

• Cardiac magnetic resonance imaging, or MRI, is a test that uses a magnetic field and computer-generated radio waves to produce a detailed image of the blood flow to the heart.

How Is Ventricular Fibrillation Treated?

Ventricular fibrillation is a cardiovascular emergency that requires emergency medical management to prevent sudden cardiac failure. The goal of emergency treatment for ventricular fibrillation is to restore blood flow as rapidly as possible to avoid any kind of organ or brain damage.

Mentioned below are a few treatment modalities for ventricular fibrillation.

Cardiopulmonary resuscitation (CPR), mimics the pumping function of the heart and helps to keep the blood flowing throughout the body. Automated external defibrillator or AED. Defibrillation is also called cardioversion which helps to restore the standard heart rhythm. If the patient remains in ventricular fibrillation, pharmacological treatment should be started. The first drug given is epinephrine and can be repeated every three to five minutes and if the epinephrine is not effective, amiodarone 300 mg is the drug of choice.

• Amrit-arrhythmic drugs.

• Other treatments for ventricular fibrillation are given to prevent future episodes and reduce your risk of arrhythmia-related symptoms. Treatment for ventricular fibrillation includes medications, medical devices, and surgery.

• An implantable cardioverter-defibrillator or ICD is a tiny implanted machine that continuously monitors the heart rhythm.

• Cardiac ablation is a procedure that uses heat energy or alternatively cold energy to create minute scars in the heart so that there is blockage of the abnormal electrical signals.

• Coronary angioplasty along with stent placement in case ventricular fibrillation has been diagnosed due to episodes of a heart attack.

• Coronary bypass surgery or an open-heart surgery is done in case there is the presence of coronary artery disease and aids in the improvement of blood flow to the heart. It may be done if your ventricular fibrillation was caused by coronary artery disease.

Conclusion:

Ventricular fibrillation is known as a cardiovascular emergency that demands prompt medical attention, and else it may result in the heart not being able to pump blood to the rest of the body. Emergency treatment and management of ventricular fibrillation may include defibrillation and cardiopulmonary resuscitation or CPR. A long-term management plan can be the insertion of an implantable defibrillator. Medications may additionally be advised to avoid the recurrence of ventricular fibrillation. Maintaining a healthy lifestyle by including a heart-smart diet and regular physical activity is key to keeping any cardiovascular conditions, such as ventricular fibrillation, at bay.