Ventricular fibrillation

Dr. med. Andrea Reiter is a freelance writer for the medical editorial team.

More about the experts All content is checked by medical journalists.

Ventricular fibrillation is a life-threatening arrhythmia. The heart is no longer able to pump blood and the affected person passes out within seconds. If left untreated, this arrhythmia leads to death within minutes. Read all about the causes and treatment of ventricular fibrillation.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. R00I48I46I47I49I45I44

Ventricular fibrillation: description

Ventricular fibrillation is a rhythm disturbance that originates in the ventricles of the heart. It is always life-threatening and can lead to death within minutes.

Normally the muscle cells of the heart chambers contract 60 to 80 times per minute. The blood collected in the heart chambers is pumped into the body's circulation through a coordinated contraction of the heart muscle, the heartbeat. Between heartbeats, the heart chambers refill with blood.

The signal for a heartbeat is generated in the so-called sinus node, which is located in the atria. This electrical signal is transmitted in an orderly manner and goes out when all muscle cells are contracted. In ventricular fibrillation this order is suddenly disturbed. So-called circular excitations arise in the chamber. Frequencies of up to 800 per minute can occur.

Due to this very fast frequency, however, effective heartbeats no longer occur in ventricular fibrillation. Because due to the far too large number of disordered excitations, the muscle cells can no longer contract synchronously. Blood is therefore no longer pumped into the body's circulation. A pulse can no longer be felt in those affected. Cardiac arrest occurs.

Ventricular fibrillation: symptoms

The symptoms of ventricular fibrillation are similar to those of cardiac arrest. Those affected are unconscious, pale, their lips are blue, their pupils are wide and rigid. Breathing stops. A pulse cannot be felt. Sometimes those affected got wet or poo.

Ventricular fibrillation: causes and risk factors

In most cases, ventricular fibrillation is caused by a serious heart disease, such as a heart attack. But ventricular fibrillation can also have many other causes:

• coronary artery disease (CHD)
• Bulging on the walls of the heart (heart wall aneurysm after myocardial infarction)
• pronounced heart failure
• Inflammation of the heart muscle (myocarditis)
• congenital heart defects
• Pulmonary embolism
• Electricity accident
• Medicines, drugs, poisoning
• Lack of oxygen (suffocation, drowning)
• Disorders of the mineral balance (e.g. potassium deficiency)
• Fluid build-up in the pericardium (pericardial effusion)
• congenital malformation in the conduction system of the heart

Ventricular fibrillation: diagnosis and examination

Ventricular fibrillation is always a life-threatening event. There is no time for an extensive physical examination. If the person concerned is unconscious and the pulse can no longer be felt, resuscitation measures must be started immediately without a diagnosis and the emergency doctor must be called.

If a defibrillator is available, the electrodes are taped or held on the chest. The defibrillator analyzes the heart rhythm. In a so-called electrocardiogram (EKG), ventricular fibrillation becomes visible through a "flicker wave". A publicly accessible defibrillator (AED) can use software to provide the layperson with instructions on what to do.

Ventricular fibrillation: treatment

With ventricular fibrillation, an attempt must be made to bring the heart rhythm back into the right rhythm by means of an electric shock. Electricity is briefly passed through the electrodes into the patient's body at the push of a button. Because all muscles receive an electrical impulse at the same time, their subsequent activity can be synchronized again. If the resuscitation is successful, the heart starts beating again. The earlier defibrillation is performed, the better the chances of survival for those affected. Sometimes the process has to be repeated.

If people have a high risk of ventricular fibrillation due to heart disease, a so-called implantable defibrillator can be used as a precaution. It is about the size of a cardiac pacemaker and continuously measures cardiac currents. If the ventricular fibrillation occurs, it emits an electric shock. So it does not protect against the arrhythmia itself, but reacts to it.

Ventricular fibrillation: disease course and prognosis

The prognosis of ventricular fibrillation depends on many factors. The time of defibrillation is particularly important. If it is carried out immediately, for example because the person concerned is already in the hospital or an AED is within reach, it will be successful in more than 95 percent of cases. The chances of survival of those affected are reduced by about ten percent for every minute of ventricular fibrillation if defibrillation is not performed.

If defibrillation was successful, it is still possible that the brain and other organs have been damaged. Especially if the resuscitation measures were carried out very late, the risk of permanent brain damage is considerable.

The risk of the arrhythmia recurring after an episode of ventricular fibrillation is high. An implantable defibrillator can reduce the risk of dying because it defibrillates immediately if ventricular fibrillation occurs. The implanted defibrillator must be checked regularly by a doctor.

If left untreated, ventricular fibrillation is always fatal. One should therefore not be afraid to resuscitate or defibrillate those affected. Possible injuries that can result are insignificant compared to the prognosis of ventricular fibrillation.

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