Ventricular fibrillation general characteristics, causes, symptoms, first aid and treatment

Ventricular fibrillation is a type of cardiac arrhythmia in which the muscle fibers of the ventricular myocardium contract chaotically, ineffectively, with a high frequency (up to 300 per minute or more). The condition requires urgent resuscitation, otherwise the patient will die.

Ventricular fibrillation is one of the most severe forms of cardiac arrhythmias, since in a few minutes it causes a stoppage of blood flow in organs, an increase in metabolic disorders, acidosis and brain damage.

Among patients who died with a diagnosis of sudden cardiac death, up to 80% had ventricular fibrillation as its primary cause.

At the time of fibrillation, chaotic, discoordinated, ineffective contractions of its cells occur in the myocardium, which do not allow the body to pump even a minimal amount of blood, therefore, following paroxysm of fibrillation, an acute violation of blood flow follows, which is clinically equivalent to that with complete cardiac arrest.

According to statistics, ventricular myocardial fibrillation more often occurs in males, and the average age is from 45 to 75 years. The vast majority of patients have some form of cardiac pathology, and causes not associated with the heart cause this type of arrhythmia quite rarely.

Ventricular fibrillation of the heart actually means stopping it; independent restoration of rhythmic contractions of the myocardium is impossible, therefore, without timely and competent resuscitation measures, the outcome is a foregone conclusion. If arrhythmia caught the patient outside the medical institution, then the probability of survival depends on who is next and what actions will be taken.

It is clear that the health worker is not always within reach, and fatal arrhythmia can occur anywhere – in a public place, park, forest, transport, etc., therefore, only witnesses of the incident can give hope of salvation, who can at least try to provide primary resuscitation care, the principles of which are still in school.

It has been proven that proper indirect heart massage can ensure oxygen saturation of blood up to 90% for 3-4 minutes even if there is no breathing, therefore it should not be neglected even when there is no confidence in the airway or the possibility of establishing artificial ventilation of the lungs.

If it is possible to maintain vital organs before the arrival of qualified care, then subsequent defibrillation and drug therapy significantly increase the patient’s chances of survival.

Causes

Cardiac fibrillation is due to the rapid contraction of the ventricles, which is erratic. The frequency of their contractions exceeds 450 beats per minute, which is an extremely dangerous phenomenon. Help should be quick, it is represented by defibrillation. Lack of help leads to death.

The causes of problems with the ventricles of the heart can be hidden in the pathology of this organ. In some cases, disorders of an extracardial nature contribute to the formation of fibrillation. Among heart pathologies, ischemic heart disease is distinguished during the acute stage of pathology in the coronary vessels associated with blood circulation.

In addition, it is necessary to name myocardial infarction, once suffered by a patient. Fatal outcome during coronary heart disease occurs in 46% of the male population and 34% of the female. Pathology is observed within 12 hours after an acute form of a heart attack.

In addition, people who have had myocardial infarction with the presence of a Q wave during paroxysmal ventricular tachycardia fall into the risk category. Ventricular fibrillation also occurs with hypertrophic cardiomyopathy, which often appears in young people after intense exertion.

In this category of the population, in this condition, ventricular tachycardia of a polymorphic nature is fixed, which, in turn, can turn into fibrillation of the ventricles of the heart.

A small number of patients, about 10%, have dilated cardiomyopathy. caused fibrillation. The pathological conditions that lead to this condition include Brugada syndrome and pancreatic cardiomyopathy. Valvular heart defects also belong to the category at risk.

They are represented by acquired or congenital aortic stenosis. However, you need to pay attention that with mitral valve prolapse, which is characterized by a large value of ventricular contractions, this pathology rarely occurs, and its occurrence in the disease is caused not by the disease itself, but by impaired heart muscle functions.

There are many reasons why this disease can occur. The main ones are:

  1. Coronary heart disease, or rather its types – myocardial infarction and acute circulatory disturbance of the coronary vessels. Especially often, ventricular fibrillation with cardiac arrest occurs in the first hours of a heart attack.
  2. Dilatation and hypertrophic cardiomyopathy. This cause of pathology leads to fibrillation at a young age, often in athletes after intense physical exertion. With dilated cardiomyopathy, up to half of patients die precisely from cardiac arrest due to ventricular fibrillation.
  3. Heart defects related to valve defects. Particularly dangerous regarding the possible development of pathology is stenosis of the aortic orifice, since it violates the filling and expulsion of blood from the left ventricle.
  4. Primary disorders of myocardial electrophysiology, including those leading to ventricular paroxysmal tachycardia (for example, WPW syndrome). Even in the absence of other pathologies and organic heart damage in some people due to congenital diseases, ventricular fibrillation may develop.

Less common causes of pathology are overdose and intoxication with cardiac glycosides, sympathomimetics, barbiturates, narcotic analgesics, and arrhythmic drugs.

Perhaps the development of the disease due to electrolyte imbalance, hypothermia.

Also, ventricular fibrillation can occur after an invasive examination – coronary angiography, after undergoing an electric shock. Rare, but quite possible causes of pathology are:

  • mitral valve prolapse;
  • specific cardiomyopathies, especially with sarcoidosis;
  • autonomic dysfunctions;
  • heart aneurysm;
  • chest wounds;
  • heart concussion;
  • acidosis;
  • severe hypoxia;
  • conducting electrical cardioversion.

In some cases, the cause of ventricular fibrillation cannot be found, so it is considered idiopathic. The most common cause of VF in adults is CHD and myocardiopathy. VF can also occur with electric shock and lightning, hypothermia and drowning.

Some drugs, especially adrenergic agonists (adrenaline, norepinephrine, dopamine) and antiarrhythmic drugs (primarily class 1: quinidine, flecainide, etacizine, as well as class 3: ibutilide, nibentan, etc.) can cause life-threatening arrhythmias transforming into fibrillation.

VF may occur with intoxication of blood circulation, if it was preceded by prolonged resuscitation; Na bicarbonate is not indicated or may even be harmful in patients with hypoxic lactate acidosis (the latter develops with prolonged cardiac arrest in non-intubated patients).

VF is preceded by tachycardia, arrhythmia, and also if a refractory / recurrent VF develops with an overdose of sympathomimetics or endogenous hypersympathicotonia. To develop against the background of electrolyte imbalance and acid-base disturbances (hypo- and hyperkalemia, hypomagnesemia, hypercalcemia, acidosis and alkalosis), hypoxia, during anesthesia, surgical operations, endoscopic studies, etc.

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Classification of the disease according to the frequency of heartbeat includes its types:

  1. Ventricular flutter is a regular sinusoidal wave with a frequency of up to 300 beats. per minute with no isoelectric wave. Flutter begins, as a rule, after paroxysm of ventricular tachycardia or an attack of atrial fibrillation.
  2. Ventricular fibrillation is an irregular heart wave with a frequency of 400-600 beats. per minute of various shapes and amplitudes. If the wave amplitude is less than 5 mm., We are talking about small-wave fibrillation, more than 5 mm. – About large-wave fibrillation.

According to the time of occurrence, ventricular fibrillation can be paroxysmal, persistent, long-term persistent, permanent (permanent form).

According to the presence of concomitant pathologies, fibrillation can be as follows:

  1. Primary Its causes are most often due to the presence of acute coronary insufficiency. From primary ventricular fibrillation, up to half of people with severe forms of coronary heart disease die. With this pathology, the risk of relapse is very high, but it responds well to treatment with defibrillation.
  2. Secondary It is expressed by ventricular fibrillation, is diagnosed in people with myocardial infarction, advanced stages of heart defects, dilated cardiomyopathy, oncological pathologies, etc. Defibrillation in this case gives a poor result. It is shared by:
    • arising against the background of another complication (for example, in a patient with myocardial infarction complicated by pulmonary edema). In this situation, the cause of ventricular fibrillation is not only a violation of excitability and conduction due to focal changes in the myocardium, but also its severe diffuse hypoxia as a result of acute cardiopulmonary failure;
    • developing like an agonal rhythm. It is observed in those cases when, at the beginning, another vital function is stopped – breathing, and only then does the heart stop;
    • ventricular fibrillation of iatrogenic origin, usually resulting from improper treatment.
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symptomatology

FG in a person can be suspected by characteristic signs:

  • after 5 sec. a person appears dizzy, weakness occurs;
  • after 20 sec. the patient loses consciousness;
  • after 40 sec. from the onset of the attack, the patient develops characteristic cramps: the skeletal muscles begin to contract once and then tonic, while defecation and urination take place involuntarily;
  • after 45 seconds pupils dilate from the onset of ventricular fibrillation; they reach their maximum size after 1,5 minutes.

The breathing of patients with ventricular fibrillation is noisy, frequent, accompanied by wheezing. By the end of the second minute, it becomes less frequent and clinical death occurs.

Symptoms of flutter and ventricular fibrillation are nonspecific. This condition always develops suddenly. Flicker is seen as a separate fluttering stage. This heart pathology is characterized by the following symptoms:

  • dizziness;
  • weakness;
  • loss of consciousness;
  • convulsions;
  • noisy breathing;
  • involuntary mikitsy and defecation;
  • dilated pupils;
  • the disappearance of the pulse in the peripheral arteries;
  • pallor or cyanosis of the skin;
  • lack of reaction of the pupils.

Depending on the time of occurrence of the first signs, primary, secondary and late fibrillation are distinguished. All of them have their own characteristics. Primary fibrillation develops in the first two days after a heart attack. Disruption of the ventricles precedes the development of heart failure and other complications.

The secondary form of fibrillation develops with existing heart failure or with cardiogenic shock.
If symptoms of fibrillation occurred more than two days after a heart attack, then this form is called late.

The first symptom of this pathological condition is dizziness. It occurs after a few seconds from the beginning of the chaotic contraction of the ventricles. After 15-20 seconds, there is a loss of consciousness. The reason is cerebral hypoxia.

After about 40 seconds, convulsive syndrome develops. In parallel, the function of the pelvic organs is disturbed. With ventricular fibrillation, mydriasis (dilated pupils) is observed. After 2 minutes, clinical death develops.

It is manifested by the following symptoms:

  • dilated pupils;
  • lack of breathing;
  • the disappearance of the pulse;
  • pallor of the skin;
  • lack of consciousness.

At the stage of clinical death, you can still help a person. If this does not happen, then irreversible changes develop. Biological death occurs. With trembling and ventricular fibrillation in the face of ongoing resuscitation measures, complications may develop in the form of aspiration pneumonia and bone fracture.

First A >

The first is emergency care for ventricular fibrillation:

  1. Precordial shock – a sharp and sharp blow to the lower third of the chest with a fist, placed on 2/3 of the forearm (part of the body from the hand to the elbow) above the chest (if the defibrillator is already ready, it is better to use it).
  2. Ambulance call.
  3. Indirect cardiac massage, preparation for defibrillation.
  4. Defibrillation with a discharge of 200 J. If ventricular fibrillation remains, a second 300 J is immediately performed, if necessary a third with an energy of 360-400 J. Large energies should not be used immediately, otherwise post-conversion complications may occur.
  5. If the first defibrillation did not help. Intracardiac or intravenous lidocaine 100-200 mg (shortens QT, which reduces the defibrillation threshold), or obzidan up to 5 mg (reduces the difference in refractoriness in different parts of the myocardium).
  6. Repeated defibrillation.
  7. If ventricular fibrillation persists – intravenous sodium bicarbonate, lidocaine infusion – 2 mg / min. (or 100 mg iv in a jet every 10 minutes), a polarizing mixture, magnesium sulfate in the composition of a polarizing mixture, or separately, in an iv jet 1-2 g for 1-2 minutes. If there is no effect, repeat after 5-10min.
  8. Third defibrillation.
  9. If ventricular fibrillation persists, continue with step 7. The introduction of adrenaline 1 mg iv can also help (in Western literature it is often recommended at the stage corresponding to No. 5, 1 mg every 3-5 min.), Calcium chloride 10% -10,0 iv. Using bicarbonate and potassium preparations, it is important to prevent the development of alkalosis and hyperkalemia.

A patient with ventricular fibrillation undergoes resuscitation, in this case an indirect heart massage in accordance with a well-defined algorithm. Defibrillation should be done as soon as possible.

Defibrillation is carried out by applying two electrodes to the chest, which will send an electric discharge, which disrupts the chaotic functioning of the heart and will allow the rhythm to normalize.

Today, as an alternative, an automatic external defibrillator is used, which should always be located in crowded places, for example, at the airport, train stations, shopping centers, and cinema.

These devices can issue clear and concise instructions and information so that life saving is successful. It is also necessary to call an ambulance. If the patient survives, he needs implantation of a cardiovent-defibrillator, that is, a device that can stop ventricular fibrillation using precardial shock.

This is an edge of the palm of the hand to the lower sternum, which helps stop fibrillation and restore normal heart rhythm. When the rhythm is restored – symptomatic therapy (vascular agents); correction of acid-base balance; prevention of ventricular fibrillation and ventricular tachycardia – lidocaine, magnesium sulfate, potassium preparations.

Defibrillation

Ventricular defibrillation is performed as follows: the patient is not anesthetized, and the discharge begins immediately with a power of 200 J. This is due to the fact that in cases of ventricular fibrillation the patient is in an unconscious state, between life and death, so there is no need for adequate pain relief can not.

Defibrillation can be performed at any place where the patient has experienced clinical death due to ventricular fibrillation. In this case, a resuscitator in a hospital or an ambulance doctor uses a portable defibrillator.

If the patient has persistent ventricular tachycardia, he can be hospitalized in the intensive care unit, where defibrillation is performed.

At the same time as defibrillation during ventricular fibrillation and flutter, general resuscitation measures are carried out – tracheal intubation, mechanical ventilation using the Ambu bag (or the ventilator, depending on the place of care), as well as the administration of adernaline, mesatone and antiarrhythmics (lidocaine, procainamide, amiodarone and etc).

Methods for defibrillation of the heart:

  • 200 J discharge
  • No effect – 360 J discharge,
  • No effect – the introduction of the drug,
  • Within 30-60 seconds resuscitation measures – discharge 360 ​​J,
  • Repeat the described activities to four categories of maximum power.

Since ventricular myocardial fibrillation is deadly, and the only way to stop it is to defibrillate with electricity, ambulance crews and medical institutions should be equipped with appropriate devices, and any health worker should be able to use them accordingly.

The heart rhythm can normalize after the first discharge of the current or after a short period of time. If this did not happen, then the second discharge follows, but with more energy – 300 J. With inefficiency, a third, maximum discharge of 360 J. is applied.

After three electric shocks, the rhythm will either be restored, or a straight line (isoline) will be recorded on the cardiogram. The second case does not speak of irreversible death, so attempts to revive the patient continue for another minute, after which the work of the heart is again evaluated.

Further resuscitation is indicated if defibrillation is ineffective. They consist of tracheal intubation for ventilation of the respiratory system and access to the large vein, where adrenaline is injected.

Adrenaline prevents the collapse of the carotid arteries, increases blood pressure, provides redirection of blood to vital organs due to spasm of the abdominal and renal vessels. In severe cases, the introduction of adrenaline is repeated every 3-5 minutes at 1 mg.

Diagnostics

This disease is diagnosed exclusively in medical institutions, by passing tests and examinations. If the patient had an attack with all of the above symptoms and was given first aid on time, then it is necessary to perform a complete diagnosis of the patient at the medical institution to determine the degree and cause of the disease.

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At the first stage of diagnosis, the doctor examines the general condition of the patient and, from the words of relatives, finds out about possible complaints and the conditions for the manifestation of the attack. In addition, the doctor should find out if the patient has already diagnosed diseases that could cause such a condition.

After this, you need to perform a physical examination, which includes checking the state of consciousness, the presence of breathing and pulse. It is also necessary to examine the skin, to study the reaction of the pupils to the light, measure the pressure, and listen to the heart.

After an initial examination, it is necessary to perform a number of tests, including a general blood test, which will help determine the presence of other diseases and a urine test, with which you can check the condition of the kidneys. The next step in the diagnosis of ventricular flutter is examination using special equipment.

Ventricular fibrillation is diagnosed as an emergency. Doctors determine the diagnosis based on:

  • Using a heart monitor. A heart monitor will allow you to read information about the electrical activity of the heart.
  • Heart rate checks. With ventricular fibrillation, the pulse is not detected.

Research to diagnose the causes of fibrillation. Additional studies may be needed to determine the causes of fibrillation:

  1. ECG. During the study, special electrodes that can record cardiac activity are placed on the chest and limbs. An ECG can detect heart rhythm disturbances or detect conduction abnormalities.
  2. Blood tests. Blood samples can be tested to check the levels of magnesium, sodium, hormones, and chemicals that can affect heart function.

Other blood tests can help identify heart damage.

  • Chest x-ray. An x-ray of the chest will allow the doctor to determine the size and shape of the heart and major vessels.
  • Echocardiography. In this study, sound waves are used to image the heart. Echocardiography can help detect areas of heart damage, areas of contractile activity and ejection fraction, as well as valve abnormalities.
  • Coronary Angiography During this procedure, a liquid contrast medium is introduced through a catheter drawn from the arteries of the limbs to the arteries of the heart.

    After filling the arteries with dye, they become visible on the X-ray screen, which allows you to identify areas of obstruction inside the vessels.

    While the catheter is inside, the doctor can perform medical procedures – angioplasty and stent placement to maintain a clear lumen of the arteries.

    CT or MRI of the heart. Although more often these studies are used to determine the presence of heart failure, other problems can be identified with their help.

    With CT, a special X-ray scanner allows you to obtain multiple images of different sections of the heart. When conducting an MRI, you will be inside a specially designed device that generates a strong magnetic field, which allows you to get images of your organs and tissues.

    ECG signs

    It is extremely difficult to distinguish symptoms of fibrillation from signs of cardiac arrest, which is associated with very similar manifestations. Therefore, it is required to rely on the data of the electrocardiogram, which allows you to make the correct diagnosis.

    In the presence of fibrillation, the cardiogram shows the formation of waves of different sizes and the disappearance of the outlines of the ventricular complex. Waves have rounded or pointed ends of heights, both upper and lower.

    Heart rate can reach large values ​​- up to 300 beats per minute or more. The amplitude of the waves is represented by two forms – small and large waves.

    The isoelectric interval in the form of individual waves is absent, most often they cross each other, and a curved line forms in a bizarre shape. In a hospital or ambulance, an ECG is done. This examination allows for differential diagnosis and an accurate diagnosis.

    With fibrillation and ventricular flutter on an ECG, there will be such signs:

    • P-teeth in most cases are absent before ventricular contractions;
    • chaotic frequent waves instead of the necessary QRS complexes;
    • with trembling, the waves will be rhythmic, with ventricular fibrillation – no.

    According to the display on the ECG, 5 stages of fibrillation are distinguished:

    1. Stage I lasting 20–30 s is characterized by the correct rhythm and a relatively high frequency of fibrillar oscillations forming characteristic “spindle” figures (the frequency of oscillations can exceed 400 in 1 min);
    2. Stage II is determined by the disappearance of the “spindles” and the random character) of the grouping of rhythmic oscillations (stage duration 20–40 s);
    3. Stage III is characterized by the absence of frequent rhythmic oscillations and the presence of double-frequency sinusoidal oscillations (the duration of the stage is 2-3 minutes);
    4. In stage IV, the ordered vibrations disappear;
    5. Stage V is a low-amplitude arrhythmic fibrillar oscillation.

    Treatment

    It is very important that immediate assistance was given for ventricular fibrillation. If there is no pulse on large arteries, an indoor cardiac massage should be done. It is also important to do mechanical ventilation.

    The latter measure is necessary in order to maintain blood circulation at a level that ensures the minimum oxygen and heart demand of the heart and brain. These and subsequent measures should restore the function of these organs.

    Typically, the patient is sent to the intensive care ward, in which the rhythm of the heart is constantly monitored using an electrocardiogram. So you can determine the form of cardiac arrest and proceed with the necessary treatment.

    In the first seconds of fibrillation, it is important to conduct electropulse therapy, which is often the only method of effective resuscitation. If electropulse therapy does not bring the expected result, they continue to conduct indoor cardiac massage, as well as artificial ventilation of the lungs.

    If these measures have not been taken before, then they begin to take them. It is believed that if the rhythm has not recovered after three categories of defibrillator, it is important to quickly intubate the patient and transfer him to the artificial respiration apparatus.

    After this, ventricular fibrillation continues to be treated with the introduction of sodium bicarbonate solution. The introduction should be carried out every ten minutes until a satisfactory level of blood circulation is restored. It is better to administer drugs through a system that is filled with a five percent glucose solution.

    In order to increase the effect of electropulse therapy, intracardiac administration of an adrenaline hydrochloride solution is prescribed. In combination with a heart massage, it enters the coronary arteries.

    However, it is worth remembering that intracardiac administration can lead to complications such as damage to coronary vessels, pneumothorax, or massive myocardial hemorrhage. Drug stimulation also involves the use of mesatone and norepinephrine.

    With the failure of electropulse therapy, in addition to adrenaline hydrochloride, it is possible to use novocainamide, anaprilin, lidocaine and ornide. Of course, the effect of these drugs will be less than the electropulse therapy itself. Artificial ventilation and heart massage continue, and the defibrillation itself is repeated after two minutes.

    If after it the heart stops, a solution of calcium chloride and a solution of sodium lactate are introduced. Defibrillation continues until the heart rate is restored, or until signs of brain death appear. Heart massage stops after a distinct ripple appears on the large arteries.

    The patient should be monitored intensively. It is also very important to take preventive measures so that re-fibrillation of the ventricles of the heart does not occur.

    However, there are situations when the doctor does not have a device at hand in order to conduct electro-pulse therapy. In this case, you can take advantage of the discharge from a conventional power supply network, where the alternating voltage current is 127 V or 220 V. There are cases when the activity of the heart was restored after a punch in the atrial region.

    Medication

    Resuscitation measures for ventricular fibrillation are aimed at restoring the sinus rhythm of the heart. The most important ways with which you can stop the development of pathology are electrical defibrillation and mechanical ventilation.

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    Doctors also practice applying precardial shock, indirect heart massage. Electrical defibrillation is initially performed “blindly” without wasting time on an ECG. Start the procedure with discharges with a capacity of 200 J, repeating them in the absence of effect with an increase in energy up to 360-400 J.

    If fibrillation persists or returns after initial success, adrenaline is required every 3 minutes, alternating it with defibrillation, while installing an ECG meter and regular monitoring of heart rhythm.

    The introduction of class 3 antiarrhythmic drugs is also used, which significantly improve the condition of the myocardium and its conductivity, normalize the rhythm (Brethilium). All drugs are administered intravenously, in the absence of effect, the dose is slowly increased.

    Other medicines that are used as measures of cardiopulmonary resuscitation:

    • Atropine;
    • Magnesium sulfate;
    • Amiodarone;
    • Lidocaine;
    • Sodium bicarbonate;
    • Novocainamide;
    • Esmolol;
    • Propranolol;
    • Amiodarone.

    In the absence of effect, resuscitation is stopped after half an hour from its beginning. Indications for the termination of emergency medical care are lack of breathing, cardiac activity, and consciousness when there is no pupil response to light.

    On the contrary, if resuscitation was successful, then the patient is transferred to the intensive care unit for subsequent treatment and observation.

    Operative intervention

    Surgery is practiced after the end of fibrillation to prevent its attacks in the future. Often a person needs the installation (implantation) of a cardioverter-defibrillator or pacemaker, so as not to die from severe types of arrhythmias that turn into ventricular fibrillation.

    Also, surgery may be necessary in the presence of organic pathology of the heart. As a rule, we are talking about eliminating valve disorders – congenital or acquired:

      Implantation of a cardioverter-defibrillator that constantly monitors heart rate.

    When the heart rate slows down, it works like a pacemaker. When ventricular tachycardia or ventricular fibrillation is detected, it works like a defibrillator to reset your heart to a normal rhythm.

    More effective than taking medications.

    Coronary angioplasty and stenting.

    This procedure is for the treatment of severe coronary artery disease, which opens blocked coronary arteries, restores blood flow and blood supply to the heart muscle.

    If ventricular fibrillation was caused by an ischemic attack, the procedure can reduce the risk of episodes of ventricular fibrillation.

    Using a catheter, which is inserted through the artery on the leg, a balloon is inflated to the coronary narrowed arteries, which expands them. Coronary angioplasty can be done during coronary catheterization (angiography)

    Surgical intervention to establish a shunt to bypass the narrowed section of the artery, a minimally invasive version of the operation is also possible.

    Restores normal blood flow, prevents ischemia of the heart muscle and ventricular fibrillation.

    Catheter ablation is sometimes performed to stop the attacks of ventricular tachycardia. Ablation is usually carried out using a catheter, on the tip of which is an electrode that supplies radio frequency pulses.

    With their help, scars or areas of heart tissue that cause abnormal heart rhythms are destroyed. After an episode of ventricular fibrillation, examination and treatment is best done in a specialized cardiology center, where there are the most modern methods for diagnosing and treating heart diseases.

    Rehabilitation and complications

    After ventricular fibrillation, the patient is monitored. His condition is constantly monitored by Holter ECG: done continuously for 1-7 days. Treatment is aimed at preventing the recurrence of seizures.

    If patients have fibrillation due to heart disease, then surgery is performed. Surgeons can install an apparatus that will correct the rhythm of the myocardium.

    The method of radiofrequency ablation is also used – this is the introduction of a special device that destroys the pathological focus of irregular heart rhythm. Medical antiarrhythmic therapy is also carried out. Anticoagulants are prescribed to prevent possible complications.

    They prevent an increase in blood coagulability and reduce the likelihood of a heart attack. They also recommend drugs that improve metabolism and nourish muscles.

    It is vital that a person with ventricular fibrillation be provided with immediate assistance, followed by treatment in a cardiology hospital. If this does not happen, an adverse outcome may occur within 30 minutes – 1 hour.

    Complications of transferred ventricular fibrillation – coma and violation of neurological functions (intelligence, speech, memory and others). They arise due to the death of brain cells during oxygen starvation, which occurs from the onset of an arrhythmia attack.

    As a result of a serious condition and coma, you may experience:

    • aspiration pneumonia caused by particles from the stomach into the lungs;
    • “Stunning” myocardium, accompanied by a constant decrease in contractility of the heart;
    • convulsive attacks.

    With indirect heart massage, fractures of the sternum and ribs often occur. Do not blame the doctor who helped the patient. It is sometimes believed that such fractures are an indicator of effective resuscitation efforts.

    The prognosis for ventricular fibrillation is always serious and depends on how quickly the resuscitation actions begin, how professionally and efficiently the specialists work, how much time the patient will have to spend virtually without heart contractions:

    • If blood circulation is stopped for more than 4 minutes, then the chances of salvation are minimal due to irreversible changes in the brain.
    • The prognosis at the start of resuscitation in the first three minutes and defibrillation no later than 6 minutes from the start of an arrhythmia attack may be relatively favorable. In this case, the survival rate reaches 70%, but the frequency of complications is still high.
    • If resuscitation assistance is late, and since the onset of paroxysm of ventricular fibrillation 10-12 minutes or more have passed, then only a fifth of patients have a chance to stay alive even if a defibrillator is used. Such a disappointing indicator is the result of rap >

    The prognosis for health with ventricular fibrillation is often poor. Even with timely resuscitation, patients become disabled. Life expectancy is decreasing. Adequately resuscitation measures can save 7 out of 10 people.

    Circulatory arrest for 4 minutes or more leads to severe encephalopathy. Ventricular flutter and fibrillation are the main cause of death in patients after resuscitation.

    The main measure for the prevention of ventricular fibrillation and flutter is the timely detection and treatment of underlying diseases (coronary heart disease, congenital and acquired defects, cardiomyopathy).

    It is necessary to exclude possible risk factors for the development of cardiovascular pathology. To do this, it is recommended:

    • eliminate stressful situations;
    • Healthy food;
    • give up alcohol and cigarettes;
    • move more;
    • normalize sleep;
    • limit physical activity.

    Fibrillation most often develops against a background of acute heart attack. To reduce the likelihood of acute cardiac ischemia, hypertension, atherosclerosis and thrombosis should be treated. Thus, fibrillation is a life-threatening condition and requires immediate resuscitation.
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  • Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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