Ventricular Fibrillation

Question 1

Define ventricular fibrillation

Answer 1

Life-threatening rapid irregular ventricular activation -> poor ventricular contraction -> no
cardiac output

Question 2

What are the causes/risk factors of ventricular fibrillation?

Answer 2

• Coronary artery disease
• Acute MI
• VT
• Cardiomyopathy
• Long QT syndrome
• Brugada syndrome – disorder of
myocardial sodium channels
• Wolff-Parkinson-White syndrome
(induced by AF -> VF)
• Congential structural
abnormalities
• Electrolyte abnormalities
• Drugs
• Electrocution

Question 3

What are the signs of ventricular fibrillation?

Answer 3

Prodrome
• Asymptomatic
• Chest pain
• Palpitations

Question 4

What are the signs of ventricular fibrillation?

Answer 4

Cardiac arrest
• Agonal/cessation of breathing
• Hypotension
• Unconsciousness
• Pulseless

Question 5

What investigations are carried out for ventricular fibrillation?

Answer 5

• ECG
- Irregular chaotic
- Evidence of Brugada, previous MI, long QT
• Bloods
- U&Es – low K+/Mg2+
- Troponin and CK-MB – MI
- Toxicology screen and serum drug levels
• Echocardiogram – structural heart disease, cardiomyopathy, RWMA (previous MI)

Question 6

What is the management for ventricular fibrillation?

Answer 6

• Defibrillation
• ALS algorithm
- CPR, defibrillation, 1mg adrenaline every 3-5 mins, 300mg amiodarone
• Implantable cardiac defibrillator

Question 7

What are the complications for ventricular fibrillation?

Answer 7

sudden cardiac death