Ventricular Fibrillation 101 - A Complete Guide

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Ventricular fibrillation, or v-fib for short, is one of several types of heart arrhythmias, or irregular heartbeats. Others include atrial fibrillation, sick sinus syndrome, ventricular tachycardia, and multiple others. However, v-fib is the most serious of all the arrhythmias, and indicates a life threatening condition is present. Anyone experiencing the symptoms of ventricular fibrillation, or a heart attack associated with v-fib, should see immediate medical attention.

The primary difference between the various types of heart arrhythmia is where fibrillation is present. In ventricular fibrillation, the heart’s rhythm is disrupted due to erratic electrical impulses being received. This causes the pumping chambers of the heart (the lower section) to quiver, rather than actually beating causing little or no blood to pump through the heart. This leads to cardiac arrest and complete collapse within seconds of onset. If treatment is not provided or is not delivered in time, death can result.

Note that non-sustained ventricular fibrillation, in which the condition lasts less than 30 seconds, no symptoms may be present. The condition may indicate a deeper and much more serious heart condition in these situations.

Signs and Symptoms of Ventricular Fibrillation

In terms of symptoms, v-fib sufferers may experience any of a range of symptoms. Some patients may collapse or fall unconscious almost instantly depending on the severity of the incident (the lack of blood flow to the heart and the brain). However, some of the more common symptoms found with milder VF incidents include:

  • Shortness of breath
  • Pain the chest
  • Nausea
  • Rapid heartbeat
  • Irregular heartbeat
  • Dizziness
  • Brief seizure followed by unconsciousness
  • Brain damage
  • Coma

Note that many of these symptoms are the same as for cardiac arrest. Ventricular fibrillation and cardiac arrest are very closely related, and one can lead to the other very quickly. In many cases, the signs of v-fib or cardiac arrest are not noticed by the patient suffering them, but by a bystander, or a medical professional. If you or a loved one experience the symptoms mentioned above, immediate medical attention is necessary.

Causes of Ventricular Fibrillation

The underlying causes of ventricular fibrillation are not well understood. The primary cause is a disruption in the electrical impulses traveling through the heart after an initial heart attack In some patients, an initial heart attack and related scar tissue is the underlying cause of ventricular fibrillation, although v-fib can also cause cardiac arrest in its own right.

However, most cases of v-fib are linked to heart disease in some way, and occur in patients with an existing heart-related problem (scarring from previous heart attacks, valve problems, etc.).

Other causes can include sepsis due to an infection in the body, drug toxicity, aorta problems, and cardiomyopathy. Shock, in which the body’s blood pressure drops very low, is also a cause, as is electrical shock and drowning. The use of sodium channel blockers and potassium channel blockers may also cause ventricular fibrillation.

Risk Factors to Be Aware Of

While ventricular fibrillation can technically affect anyone, there are risk factors that can increase vulnerability. These include a range of different lifestyle, health and medical history-related issues, including the following:

  • Have had a previous heart attack (presence of scar tissue exacerbates the risk)
  • Have experienced ventricular fibrillation in the past
  • Suffer from a pre-existing heart defect, including valve deformities
  • Damage or injury to heart muscles in some way
  • Electrolyte abnormalities such as high/low magnesium or high/low potassium, particularly very high levels of potassium
  • Both long QT syndrome and short QT syndrome
  • Using many types of illicit drugs (cocaine, etc.)
  • Suffering from a heart condition, including coronary artery disease, or cardiomyopathy
  • A sudden blow to the area of the chest directly above the heart (commotion cordis/sudden cardiac death)
  • A family history of sudden death (sudden cardiac arrest)
  • Tobacco use or heavy consumption of alcohol
  • Obesity

Important Statistics Surrounding Ventricular Fibrillation

According to the most recent information released by the American Heart Association and the Sudden Cardiac Arrest Foundation, there are over 347,322 out-of-hospital cardiac arrests annually in adults within the United States.

Of those, almost 20% were preceded by an initial arrhythmia (ventricular fibrillation or ventricular tachycardia). These present the potential to shock the heart back into the correct rhythm using an automated external defibrillator (AED). 7.2% of cardiac arrests experienced by children fall into the same category.

A study conducted in Sweden and made available through the US National Library of Medicine indicates that ventricular fibrillation is seen in a high incidence in out-of-hospital cardiac arrest patients, and that it transforms slowly into a non-shockable rhythm. With swift treatment, the study’s authors point out that the survival rate for these attacks is 50%, but survivability declined sharply with treatment delay.

Treatment Options for Sufferers

The single most effective treatment option for ventricular fibrillation is the prompt application of CPR, followed by the use of an AED, or automated external defibrillator. Failure to shock the heart back into proper rhythm can result in sudden death.  Lifesaving treatment is necessary for any patient experiencing v-fib symptoms.

If the patient has experienced a heart attack and are not in shock, and ventricular fibrillation occurs, the only course of treatment is cardioversion. This is successful in 95% of cases. However, if the patient is in shock and v-fib presents, the success rate drops to just 30%.

After experiencing ventricular fibrillation, some physicians may prescribe medication to help prevent the condition from recurring.

For some patients, surgery is necessary. Catheter ablation involves the destruction of heart tissue within the ventricles to prevent the out of synch electrical signals that cause the problem in the first place. Note that ablation is not widely used as a treatment option. Procedures surrounding stent implantation or angioplasty, other types of surgery, may be required  t may be required depending on the underlying conditions, including coronary bypass surgery.

Finally, a second type of surgery may be recommended for v-fib patients called left cardiac sympathetic denervation, this procedure is relatively rare, and focuses on treating patients with a genetic predisposition for uncontrolled ventricular fibrillation.

As you can see, there are ultimately very few treatment options available for v-fib patients. CPR followed by AED application are both vital to saving the individual’s life. Afterward, surgery and medication may be used to reduce the chances of experiencing v-fib again. However, many patients who experience v-fib a first time will have a second incident, particularly if they do not make any lifestyle changes.

The After Effects of Ventricular Fibrillation

If left untreated, or treatment is not provided as quickly as possible, one very likely outcome of v-fib is death. However, even patients who receive timely treatment may still be in danger because of the reduction in blood flow to the heart and the brain during the incident.

Some patients may ultimately be in a coma for a time after experiencing ventricular fibrillation. They may wake in hours, days, months or longer. In some worst-case scenarios, the coma may be persistent.

Some patients awake from v-fib induced unconsciousness with memory impairment, and even with some degree of brain damage due to the blood deprivation.

Prevention and Safety Considerations

While there are few treatment options for ventricular fibrillation, that does not mean you or your loved one are without hope. There are ways to prevent v-fib in the first place, even if you are genetically predisposed to heart conditions. There are also things you can do to greatly increase your safety, as well as your chances of living through an episode of ventricular fibrillation.

Testing

The first step for those who have not experienced ventricular fibrillation, but are genetically linked to heart related problems, is to get tested. Imaging, and medical testing including x rays, stress tests, echocardiograms, or electrophysiological studies can help determine if you are at risk for v-fib. From there,  your doctor can help you make changes, and recommend medications that will reduce your chances of experiencing an incident. Arrhythmia medications are particularly important for those who have experienced an irregular heartbeat and have a predisposition to heart conditions.

Using an AED

In addition to consulting with your doctor,  if you have previously experienced v-fib, or have a genetic predisposition or other heart health issues, it is also a good idea to purchase an automated external defibrillator (AED) and keep it with you. In some severe cases, your doctor may actually recommend that you have an ICD, or implantable cardioverter defibrillator, implanted. Note that this is only recommended for patients with the highest level of risk.

Important Lifestyle Changes

While genetics plays a role in your likelihood to experience ventricular fibrillation, lifestyle factors that affect your heart health are just as likely to lead to this condition, as well as to sudden cardiac arrest. Whether you have already survived a ventricular fibrillation event, or are concerned that you may face one, lifestyle changes can help prevent it. What changes should you make?

Diet

One of the most significant steps you can take toward better heart health overall is to change your diet. Most Americans follow a high-fat diet rich in highly-processed foods. The remedy to that is to eat a diet rich in fruits and vegetables, low in fat, and low in red meat.

Exercise

Another vital consideration in combatting your risk for dangerous heart conditions is to get enough exercise. Starting slow is key here, rather than joining a gym right away, start out with a daily 30-minute walk. From there, move up the intensity and duration as you are able. The hardest step is simply getting started – carve the time out of your busy schedule, and start with simple steps. Those will lead eventually to larger goals and major changes in your body.

Managing Stress

Mental stress is a significant factor in heart health. An otherwise healthy individual who is under a great deal of stress at home or work is at as much risk for adverse heart conditions as someone who overeats and does not get sufficient exercise. There are dozens of ways to deal with stress in your life, from daily prayer or meditation to cutting problem individuals out of your life if necessary. Whatever you choose, take control of your mental health and find the calmness that you need.

Smoking

Tobacco use has a myriad of negative impacts on the body, including on the heart and overall circulatory system. Quitting can greatly reduce your chances of experiencing ventricular fibrillation.

Alcohol

Some alcohol consumption has been linked with an overall improvement in heart health. However, moderation is the key. Heavy drinkers are at a significant risk for developing a host of negative heart health conditions, including ventricular fibrillation.

Weight Management

Weight management is as important as following the right diet and getting the right amount of exercise. There are very few lifestyle factors that have as large an impact on your heart health as your overall weight. A healthy body mass index (between 18.5 and 24.9) is vital to the overall health, but also helps stave off other lifestyle diseases, like diabetes, hypertension, stroke, and more. Weight management can even reduce your chances of developing certain types of cancer.

Hypertension and Cholesterol

Your blood pressure and your cholesterol level both play a role in your likelihood to experience ventricular fibrillation. If you have high blood pressure and are not controlling it medically, speak with your doctor. Eating a healthy diet and getting plenty of exercise will also help reduce your blood pressure. Note that a healthy diet will also help you drop your cholesterol levels.

Alternative Options

There are quite a few alternative options available that can help you improve your cardiovascular health. One of the alternative options has been mentioned previously– meditation. It can be very useful in combating and managing stress in your life, but can also play a role in healthier living overall.

Another option is yoga – it can be incorporated into your fitness regimen with ease, and there are levels ideally suited for any physical condition. Finally, you’ll find a number of relaxation techniques out there, ranging from aromatherapy to massage that help you de-stress and relax.

In Conclusion

In the end, ventricular fibrillation is a life-threatening, dangerous condition that can easily lead to coma, brain damage and even death. While it is linked to your genes, lifestyle choices play a central role in determining whether or not you experience an incident. If you have a family history of sudden cardiac arrest, or suspect that you have an irregular heartbeat, immediate medical testing is important. Follow your doctor’s advice and guidance on treatment options. Manage your weight, eat a healthy diet, get plenty of exercise, and you’ll greatly reduce your chances of experiencing v-fib.

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