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This page will provide you with a comprehensive overview on ventricular fibrillation pathophysiology, the symptoms of ventricular fibrillation, management of ventricular fibrillation, and the treatment of ventricular fibrillation. We sincerely hope that our website helps to further your understanding on the topic of ventricular fibrillation. If you have further questions, please contact a healthcare professional.
What is ventricular fibrillation?
Ventricular fibrillation (VF), the most commonly identified arrhythmia in cardiac arrest patients, is a condition in which there is an uncontrolled twitching or quivering of muscle fibers in the lower chamber of the heart. This condition is caused by uncoordinated contractions of the ventricle cardiac muscles and results with a dangerously low cardiac output. Ultimately, the lack of cardiac output means blood is no longer pumped out of the heart, and thus, the patient is in cardiac arrest.
Premature ventricular fibrillation
In contrast to ventricular fibrillation, premature ventricular fibrillation (also called premature ventricular contraction) is much more common and much less dangerous of a condition. In premature ventricular fibrillation the heart’s electrical activity is disrupted and, as the name suggests, the heart’s ventricles contract too soon. This causes a brief pause in heartbeat and is sometimes reported as a “thump” by patients; the ventricles fibrillate rather than “beat.” The significance of this condition to ventricular fibrillation is that if you have heart disease or a history of ventricular tachycardia (rapid heartbeat), it can cause a more serious arrhythmia in the long term.
Ventricular fibrillation pathophysiology
Automaticity, a measure of the propensity of a fiber to initiate an impulse spontaneously, is an important part of ventricular fibrillation pathophysiology. Ventricular fibrillation pathophysiology often results from the products of a hypoxic myocardium, hyperirritable myocardial cells, acting as a pacemaker (a part of the body that controls the rhythm of the heart). In a normally functioning heart there is one pacemaker that ensures the entire heart is contracting in a coordinated, timely, scheduled manner. On the contrary, the presence of many hyperirritable myocardial cells means that the ventricles are being stimulated by more than one pacemaker, and thus, causing abnormal automaticity. It is important to note that the scar and dying tissue are unimportant as they are unexcitable, but the hypoxic tissue located around these areas is crucial as it is very excitable. If ventricular fibrillation is left untreated, it will quickly degenerate into asystole, a state of no cardiac activity. This means the patient’s heart will no longer function and the body will experience significant cell death due to the lack of oxygen. Moreover, patients who are not revived soon enough (within about five minutes at room temperature) can sustain irreversible brain damage and can become brain-dead because of cerebral hypoxia. It is therefore vital for every person to recognize the signs of ventricular fibrillation and use preventative measures for the management of ventricular fibrillation; the treatment of ventricular fibrillation is unfavourable due to its urgency and potentially permanent outcome.
Symptoms of ventricular fibrillation
The symptoms of ventricular fibrillation are important to recognize because of their rapidly occurring detrimental effects. When oxygenated blood stops flowing throughout the body, vital organs, such as the brain, are starved for oxygen and the cells begin to die.As a result of this treatment must be prompt.
Symptoms of ventricular fibrillation include:
• Chest pain
• Rapid heartbeat (tachycardia)
• Shortness of breath
• Loss of consciousness (the most common symptom)
Immediate signs of ventricular fibrillation:
• Sudden loss of responsiveness (no response to tapping on shoulders)
• No normal breathing (the victim is not breathing or is only gasping)
• Sudden cardiac arrest (SCA) (heart is not beating)
It is important to note that the symptoms of ventricular fibrillation will vary depending on the underlying cause. For example, a patient suffering from ventricular fibrillation with history of coronary heart disease may feel more chest pains than an individual that is suffering from it due to a medicinal overdose. Moreover, because the symptoms of ventricular fibrillation are typically general they may be accidentally attributed to other conditions as well.
Treatment of ventricular fibrillation
The treatment of ventricular fibrillation is a medical emergency because it is the matter of life and death. Since ventricular fibrillation is a form of cardiac arrest, 911 must be called immediately and CPR should be performed. CPR involves mouth to mouth breathing and chest compressions. If available, it is recommended to use a computer controlled device called an automatic external defibrillator (AED). Defibrillation is the definitive treatment of ventricular fibrillation because an electrical current is applied to the ventricular mass to depolarize enough of the myocardium for coordinated contractions to occur again. AEDs are preferable in the treatment of ventricular fibrillation because they allow a person without medical training to pass a quick electrical shock through the chest, and thus, change the ventricular fibrillation to a normal rhythm.
Management of Ventricular Fibrillation
An important consideration for the management of ventricular fibrillation is prevention. This is simply because the condition can be instantly fatal and causes permanent myocardial cell death. Importantly, most people with ventricular fibrillation have no history of heart disease but do have risk factors contributing to cardiovascular disease, such as smoking, high blood pressure and diabetes. The overall goal of each person should be to reduce or eliminate as many of these risk factors as possible because the consequences are too severe.Physicians and health professionals often recommend making small, simple changes to a person’s lifestyle, such as a diet full of fruits and vegetable, adequate amounts of exercise, and stress control, to aid with the management of ventricular fibrillation.
In contrast, some common causes for people with a history of heart disease may include cardiomyopathy, certain arrhythmias, ischemia (lack of oxygen to the heart muscle because of narrow coronary arteries or shock), sudden cardiac death and electrocution accidents. In these cases a person may require an implantable defibrillator or medication to help prevent future episodes.
For any additional information on the management of ventricular fibrillation or the signs of ventricular fibrillation, please contact your local healthcare professional.