Causes of Ventricular Fibrillation

Introduction

Ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia characterized by rapid, chaotic electrical activity in the ventricles. This leads to the heart being unable to pump blood effectively, causing sudden cardiac arrest.

Main Causes

1. Coronary Artery Disease (CAD)

  • The most common cause of VF.
  • Blockage of coronary arteries reduces oxygen supply to the heart, leading to myocardial infarction (heart attack), which can trigger VF.

2. Acute Myocardial Infarction (Heart Attack)

  • Damage to heart muscle disrupts normal electrical conduction, causing arrhythmias.
  • Scar tissue from past heart attacks increases the risk.

3. Cardiomyopathies

  • Conditions like dilated or hypertrophic cardiomyopathy weaken the heart muscle, making it susceptible to electrical instability.

4. Electrolyte Imbalances

  • Low potassium (hypokalemia) or high potassium (hyperkalemia) affects electrical impulses.
  • Low magnesium (hypomagnesemia) can trigger ventricular arrhythmias.

5. Severe Electrical Disturbances

  • Long QT syndrome, Brugada syndrome, and Wolff-Parkinson-White syndrome can increase VF risk.

6. Drug Toxicity and Overdose

  • Certain medications (e.g., antiarrhythmics, antidepressants, stimulants) can trigger VF.
  • Cocaine and methamphetamine use increase the risk of fatal arrhythmias.

7. Electrical Shock or Trauma

  • High-voltage electrical shock can directly cause VF.
  • Severe chest trauma can alter heart conduction pathways.

8. Congenital Heart Conditions

  • Some people are born with structural or electrical abnormalities that predispose them to VF.

9. Severe Heart Failure

  • A failing heart is more prone to electrical dysfunction due to poor cardiac output and oxygenation.

Conclusion

Ventricular fibrillation is a medical emergency requiring immediate defibrillation to restore normal rhythm. Identifying and addressing underlying causes is key to prevention.

Source recommendations

1. American Heart Association Guidelines on Cardiac Arrest

  1. https://www.heart.org/en/health-topics/cardiac-arrest
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194
  3. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
  4. https://professional.heart.org/en/guidelines-and-statements
  5. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines

2. European Society of Cardiology Guidelines on Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  4. https://pubmed.ncbi.nlm.nih.gov/36017572/
  5. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84

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