VF

Ventricular fibrillation is a medical emergency and should be treated immediately to preserve life. Whether the person having VF suddenly falls unconscious at home or in the street, or the person is in the hospital (and VF is diagnosed from a cardiac monitoring station), it is indispensable to initiate immediate cardiopulmonary resuscitation (CPR). If VF occurs in the hospital, prompt medical attention is usually available and is more likely to be successful.

During an out-of-hospital cardiac arrest:

• Call 911 for emergency help.
• Until help arrives, position the unconscious person’s head and neck in line with the rest of the body to help the person breathe.
• The carotid arteries are located at each side of the neck, just below each angle of the jaw. Place your fingertips on one of the carotid arteries to try to find a pulse. Not finding a carotid pulse after several attempts is usually a sign that no pulse is present.
• Start CPR with mouth-to-mouth breathing and chest compressions.
• Continue CPR until the person regains consciousness or help arrives.

Paramedics will quickly examine the person while continuing CPR. VF is treated by using an external defibrillator, which delivers a quick electric shock through the chest. The electrical shock can immediately convert the VF into a normal rhythm. Stabilizing the heart rhythm and function may require medicines, which will be given through a vein as needed.

Once the VF has been converted to normal heart rhythm (and the patient has been transferred to the hospital, if resuscitated in the street), and to prevent further episodes of VF, the cardiologist will look for potential causes of the arrhythmia. The causes most commonly involved are ischemic heart disease and cardiomyopathies.

Victims of VF may never convert to the normal rhythm, or they may die (within a few minutes or a few days of the VF) from cardiac failure or VF complications. For out-of-hospital cardiac arrest, the survival rates of VF are slim and range between 2% and 25%.

People who have survived an episode of VF are prone to have another episode, and should be evaluated by an electrophysiologist. Currently, many VF survivors are offered therapy through an implantable cardioverter defibrillator (ICD), a device that is similar to a pacemaker and that can electrically treat new episodes of VF as soon as they occur. The ICD has shown to effectively prevent sudden cardiac death.

The most common complication of VF is sudden death (death within 1 hour of the onset of symptoms), followed by death in the hospital (among people who were transferred to a hospital after being rescued at home, in the street, or in the workplace). For survivors of VF, complications include coma, reduced mental acuity, and neurological problems similar to those seen after a stroke.

The neurological status of patients with coma after resuscitation from out-of-hospital cardiac arrest can apparently be improved with the use, in the hospital, of moderate hypothermia (i.e., low body temperature).

If someone is having VF, paramedics should called immediately at 911.

After surviving an episode of VF, your doctor should be informed as soon as possible so that cardiac treatment and prevention can be coordinated for you.