The appearance of arrhythmic, ineffective and uncoordinated contractions of muscle groups of the ventricles of the heart is called fibrillation.
In this condition, pressure is not created in the ventricles. The heart stops working like a pump that pumps blood.
Features of the disease
Ventricular fibrillationheart( VF) is characterized by chaotic contractions of the myocardial tissues .Their frequency rises from 250 to 480 per minute. The movements of the ventricles cease to be coordinated. As a result, blood circulation stops, and the heart stops.
The ECG produces irregular and chaotic waves that vary in width, height and shape. At the beginning of the attack, they are high-amplitude. This is the so-called large-scale fibrillation. After the waves become low-amplitude, their duration increases. At this stage, the defibrillation efficiency is reduced by .
Often this condition occurs as a complication of extensive myocardial infarction.
Prevalence, developmental stages of
Near 75-80% of sudden deaths of , which is caused by cardiac problems, occur in VF.This disease occurs in both young and old people.
The risk group includes those patients who suffered sudden cardiac arrest .Unexpected death affects 10-30% of these patients.
Fibrillation is characterized by a disordered contraction of the heart muscle fibers. The stages of the development of the disease quickly replace each other : the patient feels weak, loses consciousness, his pupils dilate. From the onset of the attack to clinical death takes about 2 minutes.
Classification of species
Specialists distinguish 3 types of VF after the transferred heart attacks: primary, secondary and later .Although discussions on the classification of this disease are ongoing now.
Primary fibrillation occurs 1-2 days after the heart attack. It shows that the myocardium is characterized by electrical instability, to which acute ischemia has resulted.
About 60% of primary VF occurs within 4 hours, 80% - 12 hours after a heart attack. Such a fibrillation often leads to sudden death. With left ventricular failure and cardiogenic shock , a secondary VF sometimes develops in people who have had myocardial infarction.
If the fibrillation started 48 hours after the heart attack, it is called the late .About 40-60% of people who have experienced this disease die. In most cases, this fibrillation begins at 2-6 weeks after a heart attack. More often it developed in those people who suffered anterior wall of the heart. Doctors distinguish 2 types of fibrillation. If the rhythm of contractions is correct, and their number does not exceed 200-300 per minute, then we are talking about the flutter of the ventricles. With abnormal rhythm and frequency of contractions from 200 to 500 per minute.speak of flicker.
Reasons for development and risk factors
In most cases, the cause of primary and other types of ventricular fibrillation is a complication of myocardial infarction. Specialists identify such causes of VF development:
- heart IHD( acute and delayed heart attack, coronary circulation disorders);
- hypertrophic cardiomyopathy: death occurs in young people with excessive physical exertion;
- dilated idiopathic cardiomyopathy: fibrillation begins with a background of hemodynamic disorders in half of these patients;
- problems with the right ventricle( arrhythmogenic cardiomyopathy);
- different types of heart defects( most often the cause is stenosis of the aortic estuary);
- specific cardiomyopathies;
- violation of electrophysical characteristics of the myocardium.
The disease sometimes develops even in the absence of problems with the heart muscle .The risk factors, which in some cases lead to ventricular fibrillation, include:
- a sharp drop in blood volume( this causes a drop in blood pressure and an increase in the heart rate);
- severe poisoning( hypokalemia develops and the excitability of the heart increases);
- hypothermia of the body;
- hormonal imbalance, which arose due to pathologies of the thyroid gland;
- chronic stress or excessive nerve strain;
- overdose of drugs: diuretics or cardiac glycosides.
There are cases when the cause of ventricular fibrillation is not established.
Symptoms and signs of
Suspecting VF in humans can be done by characteristic features:
- after 5 seconds of .a person appears dizzy, there is a weakness;
- after 20 seconds .the patient loses consciousness;
- after 40 seconds .from the onset of the attack, the patient develops characteristic seizures: the skeletal muscles begin to tense once, while at the same time involuntary defecation and urination take place;
- after 45 seconds .From the onset of ventricular fibrillation, the pupils widen, reaching a maximum size after 1.5 minutes.
The patient sometimes manages to complain about:
- strong palpitation;
- dizziness and weakness;
- pain in the heart.
To external attributes include:
- pallor of skin and mucous membranes;
- frequent breathing, shortness of breath;
- loss of consciousness;
- absence of pulsation on large arteries.
Doctors have 4 minutes to restore the heart rhythm of .If this is not done, then the body starts irreversible changes.
Read more about the disease from the video:
Diagnosis and emergency care
Specialists determine ventricular fibrillation by external signs .If the doctor is near the patient during the onset of an attack, he diagnoses:
- rapid pulse;
- lack of rhythm;
- the difference between heart rate and pulse;
- no difference between I and II heart tones;
- wheezing in the lungs.
Prior to arrival, doctors are recommended to do so:
- Make sure that the state of clinical death has come.
- It is necessary to "start" the heart of : in the absence of a defibrillator, a sharp blow to the sternum is made.
- In those cases where the heartbeat is not restored, the begins to perform artificial respiration and heart massage .If the resuscitation is carried out by 1 person, then it makes 2 injections of 15 rhythmic pressure on the sternum.
More information on resuscitation is provided in the video:
ECG is done in the hospital or in ambulances .This examination allows for differential diagnosis and an accurate diagnosis.
With ventricular fibrillation and fluttering on the ECG there will be such signs:
- P-teeth are in most cases absent before ventricular contractions;
- chaotic frequent waves instead of the necessary QRS complexes;
- with the fluttering waves will be rhythmic, with the scintillation of the ventricles - no.
Tactics of treatment
In the hospital, all actions are directed to the to restore the heart rhythm of .These activities are called cardioversion. Doctors do indirect heart massage and artificial ventilation. Injection of air allows the body to provide oxygen.
gives good results to the electropulse therapy. The earlier it is carried out, the higher the chances of the patient to survive.
Some claim that after 3 unproductive digits of the defibrillator, intubation should be done and the patient transferred to artificial respiration.
Treat VF continue with by the introduction of sodium bicarbonate. Injections are done every 10 minutes until the blood circulation is restored.
Increase the effectiveness of electropulse therapy by intracardiac injection of the drug "Adrenaline hydrochloride" .But such injections are fraught with the appearance of complications.
If defibrillation proved ineffective, in addition to Adrenaline hydrochloride, Anaprilin, Novokainamid, and Lidocaine are administered. The patient continues to do heart massage and artificial respiration, the defibrillation is repeated after 2 minutes.
In those cases when the heart stops after the pulse therapy, "Calcium chloride", "Sodium lactate" is administered.
Rehabilitation
After ventricular fibrillation, the patient is observed.
His condition is constantly monitored by ECG Holter: is done continuously for 1-7 days .
Treatment is aimed at preventing recurrence of attacks.
If patients have fibrillation due to heart disease, then is performed by .Surgeons can install an apparatus that will correct the rhythm of the myocardium.
Also used method of radiofrequency ablation is the introduction of a special device that destroys the pathological focus of abnormal heart rhythm.
Conduct and medical antiarrhythmic therapy .To prevent possible complications appoint anticoagulants. They prevent the increase in blood clotting and reduce the likelihood of developing a heart attack. Also recommend the means that improve metabolism and nourish the muscles.
Possible consequences and prognosis of
In most cases, complications occur after VF.Better the forecast will be in those cases when help begins to have in the first seconds of the attack. But to avoid the negative consequences of this state is difficult.
When cardiac arrest occurs total myocardial ischemia .After the restoration of blood circulation, dysfunction occurs in the work of the heart muscle.
It is also possible to develop such complications:
- occurrence of arrhythmia;
- problems with lungs: aspiration pneumonia, damage to their tissues due to fracture of the ribs;
- neurological problems( arise due to temporary worsening of blood circulation in the brain tissues);
- thromboembolism: obstruction of blood vessels by blood clots.
Preventative methods, prevention of recurrence
To reduce the likelihood of VF development allows tracking the work of the heart muscle. When the slightest deviation occurs, one should consult with doctors and follow their instructions.
Doctors recommend to reconsider and lifestyle. It is necessary:
- to refuse from cigarettes, alcohol, drugs;
- to focus on vegetable food, dairy products;
- to exclude from the ration of smoked meat, fried, fatty;
- to reduce salt intake;
- lead an active lifestyle, but avoid overloading.
Provide competent timely medical care for ventricular fibrillation is difficult. After all, the attack does not always begin in the hospital. Because of this, this disease is considered the leading cause of sudden death due to heart problems with .Reduce the likelihood of its development can be if you observe the state and adhere to the foundations of the right way of life.
