What is ventricular fibrillation?
Ventricular fibrillation, or ventricular fibrillation for short, is a rhythm disorder that originates in the heart chambers. Normally, the muscle cells of the heart chambers contract 60 to 80 times per minute. During this process, blood collected in the ventricles is pumped into the systemic circulation by a coordinated contraction of the heart muscle, the heartbeat. Between heartbeats, the ventricles fill with blood again.
However, due to this very fast frequency, effective heartbeats no longer occur in ventricular fibrillation. Due to the far too large number of disordered excitations, the muscle cells no longer contract synchronously. The heart therefore no longer pumps blood into the systemic circulation. A pulse is no longer palpable in those affected. This leads to circulatory arrest. Ventricular fibrillation is therefore always life-threatening and leads to death within minutes if left untreated.
The symptoms of ventricular fibrillation are similar to those of cardiac arrest. The affected person becomes unconscious very quickly, usually after only ten to 15 seconds. They are pale, their lips turn blue, and their pupils are wide and fixed. After about 30 to 60 seconds, breathing stops. A pulse is not palpable. Sometimes those affected have wet themselves or defecated.
What are the causes of ventricular fibrillation?
- Coronary heart disease (CHD), heart attack
- Outpouching of the heart walls (heart wall aneurysm after myocardial infarction)
- Pronounced cardiac insufficiency
- Inflammation of the heart muscle (myocarditis)
- Congenital heart defects
- Pulmonary embolism
- Electrical accident
- Medication, drugs, poisoning
- Oxygen deficiency (suffocation, drowning)
- Mineral imbalances (for example, potassium deficiency)
- Fluid accumulation in the pericardium (pericardial effusion)
- Congenital malformation in the conduction system of the heart
Diagnosis and examination
If the victim is unconscious and no pulse can be felt, it is crucial and, in case of doubt, life-saving for those present to start resuscitation measures immediately without a diagnosis and to call the emergency physician.
Treatment
If ventricular fibrillation occurs in the absence of a physician or without access to a defibrillator, the first emergency action by first responders is cardiopulmonary resuscitation: first, chest compressions are given at a rate of 100 to 120 compressions per minute.
The sooner defibrillation is performed, the better the chances of survival for those affected. Sometimes, however, it is necessary to repeat the procedure. In this case, it is important to continue cardiopulmonary resuscitation between the shocks. If defibrillation is unsuccessful, the emergency physician may administer certain drugs, such as adrenaline.
If underlying conditions are present, such as heart disease or electrolyte imbalance, it is important to treat these as well to reduce the risk of recurrent ventricular fibrillation.
Course of the disease and prognosis
If defibrillation was successful, it is still possible that the brain and other organs may have been damaged. Especially if resuscitation measures were performed very late, the risk of permanent brain damage is considerable.
Ventricular fibrillation is always fatal if left untreated. It is therefore important that those present in an emergency do not shy away from resuscitating or defibrillating the affected person. Possible injuries that may occur are insignificant compared to the prognosis of ventricular fibrillation.
