(See also Overview of Arrhythmias Overview of Arrhythmias The normal heart beats in a regular, coordinated way because electrical impulses generated and spread by myocytes with unique electrical properties trigger a sequence of organized myocardial... read more .)
Ventricular fibrillation (VF) is due to multiple wavelet reentrant electrical activity and is manifested on electrocardiogram (ECG) by ultrarapid baseline undulations that are irregular in timing and morphology.
VF is the presenting rhythm for about 70% of patients in cardiac arrest Cardiac Arrest Cardiac arrest is the cessation of cardiac mechanical activity resulting in the absence of circulating blood flow. Cardiac arrest stops blood from flowing to vital organs, depriving them of... read more and is thus the terminal event in many disorders. Overall, most patients with VF have an underlying heart disorder (typically ischemic cardiomyopathy Overview of Cardiomyopathies A cardiomyopathy is a primary disorder of the heart muscle. It is distinct from structural cardiac disorders such as coronary artery disease, valvular disorders, and congenital heart disorders... read more , but also hypertrophic or dilated cardiomyopathies, arrhythmogenic right ventricular dysplasia [ARVD], or Brugada syndrome Brugada Syndrome Brugada syndrome is an inherited disorder of cardiac electrophysiology causing an increased risk of syncope and sudden death. (See also Overview of Arrhythmias.) Several different mutations... read more ). Risk of VF in any disorder is increased by electrolyte abnormalities, acidosis, hypoxemia, or ischemia.
Ventricular fibrillation is much less common among infants and children, in whom asystole is the more common presentation of cardiac arrest.
Treatment of ventricular fibrillation is with cardiopulmonary resuscitation Cardiopulmonary Resuscitation (CPR) in Adults Cardiopulmonary resuscitation (CPR) is an organized, sequential response to cardiac arrest, including Recognition of absent breathing and circulation Basic life support with chest compressions... read more , including defibrillation Defibrillation Cardiopulmonary resuscitation (CPR) is an organized, sequential response to cardiac arrest, including Recognition of absent breathing and circulation Basic life support with chest compressions... read more . The success rate for immediate (within 3 minutes) defibrillation is about 95%, provided that overwhelming pump failure does not preexist. When it does, even immediate defibrillation is only 30% successful, and most resuscitated patients die of pump failure before hospital discharge.
Patients who have VF without a reversible or transient cause are at high risk of future VF events and of sudden death. Most of these patients require an implantable cardioverter-defibrillator Implantable Cardioverter-Defibrillators (ICD) The need for treatment of arrhythmias depends on the symptoms and the seriousness of the arrhythmia. Treatment is directed at causes. If necessary, direct antiarrhythmic therapy, including antiarrhythmic... read more ; many require concomitant antiarrhythmic drugs Drugs for Arrhythmias The need for treatment of arrhythmias depends on the symptoms and the seriousness of the arrhythmia. Treatment is directed at causes. If necessary, direct antiarrhythmic therapy, including antiarrhythmic... read more to reduce the frequency of subsequent episodes of ventricular tachycardia and VF.