Ventricular fibrillation is a disturbance of heart rhythm. In it the ventricles (lower chambers of the heart) do not contract properly and merely quiver uselessly and enough blood is not pumped to the rest of the body. It is a serious medical emergency because it can cause sudden cardiac arrest, which can be fatal if not treated promptly.
The main causes are certain heart diseases, and current or previous heart attack. In a few cases the cause is unknown. Initial symptoms are chest pain, dizziness, palpitations, and nausea. More characteristic symptoms are fainting or loss of consciousness, and cardiac arrest.
Causes Of Ventricular Fibrillation
Heart attack can disturb the electrical impulses that travel through the heart to make it contract. Such disturbance can cause erratic contraction of ventricles because they are not being stimulated properly.
A previous heart attack can cause scar tissue. This scar tissue interferes with electrical impulses in the heart, leading to fibrillation.
Congenital heart disease increases the risk of ventricular fibrillation because it can interfere with the electrical activity of the heart. Other heart diseases that can lead to ventricular fibrillation are cardiomyopathy (disease of the heart muscle) and myocarditis (inflammation of the heart muscle).
Other Risk Factors
Certain drugs such as cocaine and methamphetamine can cause it. Electrocution or other trauma that damages heart muscle can cause ventricular fibrillation. Ventricular tachycardia also increases its risk. A previous attack of ventricular fibrillation increases the risk of another such attack.
Symptoms Of Ventricular Fibrillation
Ventricular tachycardia may be present prior to the full onset of ventricular fibrillation. If so, you will be aware of your own heartbeat, so-called palpitation.
This may be a regular rhythm or an irregular rhythm. You may feel it as a racing, irregular or uncomfortable heartbeat. The pulse will be fast and chaotic.
Chest pain may be experienced about an hour prior to the onset of fibrillation. It occurs due to reduced blood supply to the heart. The pain can radiate to left arm, neck or jaw. The pain may be accompanied by sweating, shortness of breath and dizziness. It can last for a long period of time.
Fainting Or Loss Of Consciousness
The blood supply to the brain is diminished on account of the ineffectively contracting heart. This deprives the brain of enough glucose and oxygen. Hence its functioning is impaired.
This may lead to a fainting episode or you may lose consciousness and become unresponsive. This is the commonest symptom of ventricular fibrillation.
With the full onset of the fibrillation, the heart will be hardly pumping any blood. You will collapse and will not respond to any tapping on the shoulders. Breathing will be absent, which can be checked by tilting the head up and checking for 5-10 seconds. Pulse will be absent at the wrist. This is sudden cardiac arrest, and needs immediate resuscitation.
Treatment Of Ventricular Fibrillation
Cardiopulmonary resuscitation needs to be administered after confirming the absence of pulse and breathing. It involves chest compressions and breathing directly into the mouth of the patient in a fixed ratio. This can be done even by laymen until professional help arrives or a defibrillator becomes available.
Defibrillation involves the delivering of a shock to the heart to jolt it back into normal rhythm. The shock is delivered with the help of a defibrillator placed on the chest wall in the region of the heart. Implantable defibrillators are available nowadays, which can correct future attacks.
Medications are not substitutes but supplements to defibrillation. They are not first priority, but occasionally become useful when defibrillation is not successful. However, drugs can be effective in preventing future attacks. Such drugs are antiarrhythmic drugs like lidocaine and amiodarone.
Procedures And Surgery
Ablation of heart muscle can be done to allow free flow of electrical activity in the heart. It is usually done by threading a catheter to the heart through a peripheral vein.
If you have coronary artery disease, you will require coronary angioplasty followed by the placement of a stent, to correct the atherosclerosis. Some require coronary bypass surgery.
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