Ventricular Fibrillation (Ventricular Flutter): Causes, Symptoms & Treatment

Ventricular fibrillation or ventricular flutter of the heart, colloquially known as cardiac fibrillation or heart flutter, is a highly threatening process for human life. It always means acute danger to life, and if ventricular fibrillation is suspected, the patient must immediately get into the hands of a doctor, who will then initiate acute emergency measures.

What is ventricular fibrillation?

Defibrillation is a treatment method for cardiac arrhythmias such as ventricular fibrillation or palpitations, atrial fibrillation, and atrial flutter in which strong electrical shocks are used to restore healthy heart activity. When ventricular fibrillation of the human heart is present, no pulse can be felt in the affected person. There are uncontrolled contractions and twitching of the heart because there is no longer an orderly heartbeat due to pathological cardiac arrhythmia. The heart muscle only pumps irregularly and, if left untreated, may not pump at all. Ventricular fibrillation often occurs as a complication during a heart attack. If the patient is not adequately treated immediately, he or she may die from ventricular fibrillation.

Causes

There are many causes of ventricular fibrillation. Cardiovascular disease is very often caused by years of smoking, but also by other organic diseases such as liver and kidney damage. Likewise, an unhealthy diet and lack of exercise promote heart disease. However, the main cause of ventricular fibrillation is a disease of the heart itself, known as coronary artery disease. It is one of the most common causes of ventricular fibrillation and sudden cardiac death. Potassium deficiency from kidney failure or from an improper high-fat diet can also lead to ventricular fibrillation. Acute shock and electric shock can also cause acute ventricular fibrillation. In rare cases, excessive stress (usually associated with a heart attack) can also indirectly cause ventricular fibrillation.

Symptoms, complaints, and signs

Onset of ventricular fibrillation (ventricular flutter) is often noticeable a few minutes beforehand by various diffuse symptoms. Affected individuals often initially experience mild dizziness and lightheadedness, which may be accompanied by severe nausea. In many cases, cold sweats, inner restlessness and a feeling of tightness in the chest also accompany the symptoms. In the further course, heart palpitations occur. The heart rate increases here to up to 250 beats per minute – normal is about 60 to 80 beats per minute. The affected person suffers from increasing shortness of breath, which can increase to acute respiratory distress. The overload of the heart often leads to left-sided chest pain, which can radiate to the left arm and shoulder. Ventricular fibrillation usually results in a cardiovascular collapse, and the affected person loses consciousness within a few seconds. Typically, the fainting person’s skin turns pale, and the lips turn blue. Usually, the pupils are dilated and fixed, and neither blood pressure nor pulse can be detected. Respiratory activity also stops. During fainting, many patients experience uncontrolled bowel or bladder emptying. In many cases, ventricular fibrillation does not announce itself via such warning signals, but occurs spontaneously and without prior signs. Some affected individuals experience only a greatly reduced physical capacity a few days beforehand.

Diagnosis and course

The patient suffering from acute ventricular fibrillation falls into deep unconsciousness after only a few seconds. Severe convulsions occur and the pupils are conspicuously dilated. The brain is now no longer supplied with oxygen. If left untreated or treated too late, ventricular fibrillation causes irreparable brain damage after only several minutes, and death inevitably follows shortly thereafter. At the slightest suspicion of ventricular fibrillation or myocardial infarction, the emergency physician initiates immediate measures. In addition, an ECG must be taken as quickly as possible to monitor the patient’s cardiac activity. In addition, the patient’s blood is immediately tested as soon as he arrives at the hospital. Many cities and counties have special ambulances equipped for acute cardiac patients in which all immediate measures can be performed. But semi-automatic defibrillators, which are now in many public facilities, can also save time and save lives.

Complications

Ventricular fibrillation is a life-threatening condition for the patient. If this condition is not treated, the patient may die in the worst case. As a rule, treatment must be given acutely by an emergency physician or directly in the hospital. Further complications and symptoms usually depend on the cause and treatment. The affected person can also lose consciousness due to ventricular fibrillation and possibly also injure themselves in the event of a fall. Likewise, the body’s entire circulatory system can fail. If the affected person loses consciousness, the internal organs and the brain can no longer be supplied with oxygen. This results in irreversible damage, so that the affected person may suffer from paralysis or sensory disturbances even after treatment. This condition is treated with the help of a defibrillator and does not usually lead to complications. However, not every patient can be saved in the process. A pacemaker may be necessary for the affected person to continue to survive. In most cases, ventricular fibrillation significantly reduces the patient’s life expectancy.

When should you see a doctor?

Disturbances in heart rhythm are among serious health symptoms that should always be evaluated by a physician. Permanent as well as temporary irregularities indicate problems with the heart’s activity, which must be clarified in a checkup. If there is pain in the chest, a stabbing or pulling sensation in the chest, palpitations as well as a change in blood pressure, a doctor should be consulted. If the person suffers from nausea, dizziness or unsteadiness of gait, there is cause for concern. If there is any abnormality in breathing, the initiation of medical examinations is strongly advised. In the case of shortness of breath, the organism is supplied with too little oxygen for a prolonged period of time. This undersupply can trigger a life-threatening condition and lead to premature death. In the event of drowsiness or loss of consciousness, emergency medical services must be alerted. First aid measures must be initiated by persons present to ensure the survival of the victim. If an uncontrollable tremor sets in or an inner restlessness develops, the first signs of a health problem become apparent. Since ventricular fibrillation is associated with a high risk to life, a reaction should be taken as quickly as possible if the symptoms increase. An emergency physician is needed in the event of a continuous increase in pulse rate, internal heat development, sweating, or a sudden cardiovascular arrest.

Treatment and therapy

First, the emergency physician or available medical personnel will initiate immediate resuscitative measures. This resuscitation should result in resuscitation of the cardiopulmonary system. Acute ventricular fibrillation is then treated with a device called a defibrillator. This device is used to restart the normal heart rhythm and heartbeat. The doctor then injects the patient with additional antiarrhythmic drugs. These drugs stabilize the cardiovascular system and cause normalization of the electrical excitation conduction of the human heart. The patient who has suffered ventricular fibrillation is taken to the intensive care unit in the hospital. With modern apparatus medicine, he is monitored seamlessly until his condition has stabilized noticeably and he can be further treated in a normal ward. Anyone who has suffered an attack of ventricular fibrillation or a heart attack once is in danger in the future of having the same thing happen to them again and not surviving it a second time. For this reason, the physician will take precautionary measures while the patient is still in the hospital to prevent a recurrence of ventricular fibrillation. The possible implantation of a pacemaker and permanent drug or surgical treatment of the original causes are usually unavoidable.

Outlook and prognosis

If the affected person does not receive immediate intensive medical care for ventricular fibrillation, the prognosis is unfavorable. The patient’s premature death is imminent, as ventricular fibrillation represents an emergency situation for the affected person and poses an acute threat to his or her life.If first aid measures are initiated immediately with the onset of ventricular fibrillation by persons present and medical care is given within a few minutes, the prospects of recovery improve. A fundamentally healthy person is at risk of long-term impairment. Saving the life is successful in most cases. In most cases, a change in the current lifestyle must be made and physical as well as emotional stress must be avoided. At any time, they can lead to a relapse of existing symptoms and trigger a renewed threat to life. If other underlying diseases are present, such as severe obesity, heart disease or kidney failure, this has an unfavorable influence on the further course of the disease. In addition to permanent damage to the organs and impairment of the functional capabilities of the organism, there is a risk of physical and psychological sequelae. The quality of life decreases significantly and a restructuring of the entire daily routine is necessary, since the usual duties can no longer be performed independently. Irreversible damage occurs, which can lead to complications and endangerment of life at any time. Paralysis or multiple surgical procedures are likely.

Prevention

Anyone who wants to prevent diseases of the cardiovascular system should definitely take advantage of the preventive examinations offered by the health insurance companies. People as young as 35 can have regular checkups. Anyone who notices irregular heartbeat or even pain in the heart area should also be examined immediately by their family doctor or a cardiologist. A 24-hour ECG can provide clarity in the case of unclear symptoms, if the normal ECG does not show any abnormalities. Smoking and excessive consumption of alcohol damage all organs and thus also the heart. Those who exercise a lot, eat a healthy diet and abstain from indulgence toxins can prevent coronary heart disease and potassium deficiency. If such a disease is already present, treatment appointments must be meticulously observed and prescribed medication must be taken without fail.

Aftercare

A survived ventricular fibrillation or ventricular flutter is a disease that must be accompanied by mandatory medical aftercare. Among other things, this concerns the defibrillator, which in many cases has been implanted in the patient’s chest for safety. Function and fit must be correct to ensure optimal protection for the patient. Furthermore, follow-up care also depends on any underlying disease that triggered the ventricular fibrillation or flutter. If structural heart disease has been identified, its progression must be monitored at regular intervals defined by the physician. This includes ultrasound and ECG, but also stress ECG, imaging techniques such as MRI or even invasive examination by cardiac catheterization. If physical fitness can be strengthened as part of follow-up care, this is also discussed with the attending physician, for example the family doctor, an internist or the cardiologist. Here, there are rehabilitation sports groups that are specially tailored to the needs of cardiological patients. Walks in the fresh air are also helpful. The diet is best cholesterol-conscious, without much fat. It is better to avoid alcohol, nicotine and too much caffeine. For psychological coping with survived ventricular fibrillation, relaxation methods or even yoga can be very helpful as part of aftercare.

What you can do yourself

As a potentially life-threatening arrhythmia of the heart, ventricular fibrillation (ventricular flutter) belongs in immediate emergency medical treatment. Because of the often rapid onset of unconsciousness, self-help by the affected patient is usually not possible. After surviving ventricular fibrillation, however, there are some behaviors that are important for the patient in everyday life. Depending on the cause of the ventricular fibrillation or flutter, the patient can actively contribute to his or her heart health in consultation with the treating family doctor, internist or cardiologist. This applies in particular to a healthy diet and a measured amount of exercise, which is possible both on one’s own and in cardiac sports groups due to the usually implanted defibrillator. Strengthening the immune system to ward off infections and reducing any excess weight are also useful.In addition, it is up to the patient to reduce the stress in his private or professional environment to a minimum as best as possible. Patients who have experienced a threatening ventricular fibrillation (ventricular flutter) also need to strengthen their mental state. Moderate exercise also helps here. In addition, psychological stabilization is just as possible through reappraisal in discussions as through a walk with the dog or learning a relaxation method such as the Progessive Muscle Relaxation according to Jacobsen. Gentle yoga styles also stabilize the inner balance of often significantly.