Ventricular Fibrillation (VF) Arrest

Introduction

Ventricular fibrillation (VF) is a life-threatening cardiac arrhythmia that results in cardiac arrest. VF occurs when the heart's electrical activity becomes chaotic, preventing the heart from pumping blood effectively. Immediate treatment is required to restore circulation and prevent death.

Causes of VF Arrest

Several factors can trigger VF, including: - Coronary artery disease (CAD): The most common cause, often due to a heart attack (myocardial infarction). - Structural heart disease: Conditions like cardiomyopathy increase the risk. - Electrolyte imbalances: Low potassium (hypokalemia) or high potassium (hyperkalemia) can contribute. - Drug toxicity: Certain drugs, such as antiarrhythmics or illicit substances, can trigger VF. - Genetic syndromes: Long QT syndrome, Brugada syndrome, and other inherited arrhythmias.

Symptoms

VF leads to sudden cardiac arrest, which manifests as: - Sudden collapse - Loss of consciousness - Absence of pulse and breathing

Immediate Treatment

Rapid intervention is critical in VF arrest: 1. Call for emergency medical help (911 in the US, 112 in Europe). 2. Start high-quality CPR with chest compressions (100-120 per minute) and rescue breaths. 3. Defibrillation: An automated external defibrillator (AED) or a manual defibrillator is required to deliver an electrical shock to restore normal rhythm. 4. Advanced medical care: Medications like epinephrine and antiarrhythmic drugs (e.g., amiodarone) may be used if initial defibrillation fails.

Prevention and Long-Term Management

For patients at risk of VF, preventive strategies include: - Implantable cardioverter defibrillator (ICD): A device that detects and treats life-threatening arrhythmias. - Medications: Beta-blockers and antiarrhythmics help reduce the risk. - Lifestyle changes: Controlling blood pressure, cholesterol, and avoiding stimulant drugs. - Management of underlying conditions: Treating CAD, electrolyte disturbances, and heart failure.

Conclusion

VF is a medical emergency requiring immediate defibrillation and high-quality CPR. Long-term management includes risk factor modification and, for high-risk patients, ICD implantation.

Source recommendations

1. American Heart Association Guidelines on ACLS and Sudden Cardiac Arrest

  1. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000916
  3. https://www.heart.org/en/health-topics/cardiac-arrest
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194
  5. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-basic-and-advanced-life-support

2. European Resuscitation Council Guidelines on Cardiac Arrest

  1. https://www.sciencedirect.com/science/article/pii/S0300957221000642
  2. https://cprguidelines.eu/guidelines-2021
  3. https://www.resuscitationjournal.com/article/S0300-9572(21)00064-2/fulltext
  4. https://link.springer.com/article/10.1007/s00134-021-06368-4
  5. https://cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-and-European-Societ.pdf

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