Ventricular Fibrillation: Diagnosis & Treatment

Diagnosing ventricular fibrillation

Diagnosing ventricular fibrillation (also called VF or v-fib) typically happens after emergency treatment because ventricular fibrillation can strike suddenly and without warning. Since VF is fatal without immediate intervention, providers focus first on terminating or controlling the arrhythmia and restoring the heart’s function before diagnosing the source or etiology of VF.

Once the heart is stabilized, doctors can perform tests to confirm VF and understand its cause. The most common diagnostic tool is an electrocardiogram (EKG or ECG), which uses electrodes placed on the body to analyze the heart's electrical activity. If ventricular fibrillation is still happening during the test, the EKG will show an abnormally high heart rate—often over 250 beats per minute. For comparison, a normal heart rate is usually between 60-100 beats per minute.

In addition to the EKG, doctors may also use imaging tests like MRIs, echocardiograms, and other heart monitoring tools to determine the condition of your heart after the event. These tests also help them assess your arrhythmia, determine its cause, and make a treatment plan.

How to treat ventricular fibrillation

Treating ventricular fibrillation (VF) happens in two phases. The first phase focuses on emergency care—resuscitating the person and restoring heart function. After the immediate danger is addressed, ongoing treatments for v-fib aim to prevent future episodes and manage underlying causes. These may include ventricular fibrillation medicines, ventricular fibrillation supportive therapy, or procedures like catheter ablation, cardiac denervention and radiation therapy.

Emergency ventricular fibrillation treatment

In the emergency phase of v-fib treatment, the immediate goal is to keep blood flowing through the body and restart the heart. Emergency treatments include:

• CPR: CPR is a lifesaving technique. Performing CPR chest compressions helps circulate blood through the body until the heart can be restarted. If you see someone collapse and become unresponsive, call 911 immediately and put the call on speakerphone. Begin chest compressions by pushing firmly on the center of the chest, about 100-120 times per minute. Follow the emergency operator’s instructions and continue compressions until help arrives.
  
  
• Defibrillation: An automatic external defibrillator (AED) can deliver an electric shock to the heart, stabilizing its rhythm and restoring function. Many public places have AEDs available that require little to no training. If an AED is available, turn it on and follow its instructions. The emergency operator on the line can help guide you through its use.

Ventricular fibrillation treatment with drugs

Once heart function is restored, doctors may prescribe an anti-arrhythmic medication to help regulate your heartbeat and prevent future ventricular fibrillation symptoms or episodes. These medications help either emergency or outpatient invasive procedures such as cardiac catheterization.

Ventricular fibrillation surgery and other therapies

For long-term prevention of ventricular fibrillation, the most common treatment is an implantable cardioverter-defibrillator (ICD). An ICD is a small device placed inside your body that monitors your heart’s rhythm. If it detects VF, it automatically delivers a lifesaving shock to stabilize you.

If an underlying condition caused your ventricular fibrillation, additional treatments might include:

• Cardiac catheterization or heart surgery: If a heart attack caused your v-fib, these procedures can restore blood flow and reduce future risk.
  
  
• Catheter ablation: This minimally invasive procedure creates small scars on the heart to block abnormal electrical signals that cause v-fib.

FAQs about ventricular fibrillation treatments