Treatments and drugs

By Mayo Clinic Staff

Emergency treatments for ventricular fibrillation focus on restoring blood flow through your body as quickly as possible to prevent damage to your brain and other organs. After blood flow is restored through your heart, if necessary, you'll have treatment options to help prevent future episodes of ventricular fibrillation.

Emergency treatments

  • Cardiopulmonary resuscitation (CPR). This treatment can help restore blood flow through the body by mimicking the pumping motion your heart makes. CPR can be performed by anyone, including family members of those at risk.

    In a medical emergency, CPR can be started before emergency medical personnel arrive. But first, call for emergency medical attention and check the unconscious person's breathing. Then begin CPR by pushing hard and fast on the person's chest — about 100 compressions a minute. Allow the chest to rise completely between compressions. Unless you've been trained in CPR, don't worry about breathing into the person's mouth. Keep doing chest compressions until a portable defibrillator is available or emergency personnel arrive.

  • Defibrillation. The delivery of an electrical shock through the chest wall to the heart momentarily stops the heart and the chaotic rhythm. This often allows the normal heart rhythm to resume.

    The shock may be administered by emergency personnel or by a bystander if a public-use defibrillator — the device used to administer the shock — is available. Most public-use defibrillators are easy to use and give voice instructions as you use them.

    Public-use defibrillators are programmed to recognize ventricular fibrillation and send a shock only when it's appropriate. These portable defibrillators are available in an increasing number of public places, including in airports, shopping malls, casinos, health clubs, and community and senior citizen centers.

Treatments to prevent future episodes

If your doctor finds that your ventricular fibrillation episode is caused by a change in the structure of your heart, such as scarred tissue from a heart attack, he or she may recommend that you take medications or have a medical procedure performed to reduce your risk of future ventricular fibrillation. Treatment options can include:

  • Medications. Doctors use various anti-arrhythmic drugs for emergency or long-term treatment of ventricular fibrillation. A class of medications called beta blockers is commonly used in people at risk of ventricular fibrillation or sudden cardiac arrest. Other possible drugs include angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers or a drug called amiodarone (Cordarone, Pacerone).
  • Implantable cardioverter-defibrillator (ICD). After your condition stabilizes, your doctor is likely to recommend implantation of an ICD. An ICD is a battery-powered unit that's implanted near your left collarbone. One or more electrode-tipped wires from the ICD run through veins to your heart.

    The ICD constantly monitors your heart rhythm. If it detects a rhythm that's too slow, it sends an electrical signal that paces your heart as a pacemaker would. If it detects ventricular tachycardia or ventricular fibrillation, it sends out low- or high-energy shocks to reset your heart to a normal rhythm. An ICD may be more effective than drug treatment at reducing your chance of having a fatal arrhythmia.

  • Coronary angioplasty and stent placement. This procedure is for the treatment of severe coronary artery disease. It opens blocked coronary arteries, letting blood flow more freely to your heart. If your ventricular fibrillation was caused by a heart attack, this procedure may reduce your risk of future episodes of ventricular fibrillation.

    Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg, to a blocked artery in your heart. This catheter is equipped with a special balloon tip that briefly inflates to open up a blocked coronary artery. At the same time, a metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to your heart. Coronary angioplasty may be done at the same time as a coronary catheterization (angiogram), a procedure that doctors do first to locate narrowed arteries to the heart.

  • Coronary bypass surgery. Another procedure to improve blood flow is coronary bypass surgery. Bypass surgery involves sewing veins or arteries in place at a site beyond a blocked or narrowed coronary artery (bypassing the narrowed section), restoring blood flow to your heart. This may improve the blood supply to your heart and reduce your risk of ventricular fibrillation.
  • Ventricular tachycardia ablation. In certain circumstances your doctors may recommend a catheter-based procedure called ablation to try to get rid of the impulses in your heart causing ventricular tachycardia. Ablation typically uses catheters — long flexible tubes inserted through a vein in your groin and threaded to your heart — to correct structural problems in your heart that cause an arrhythmia.

    Cardiac ablation works by scarring or destroying tissue that blocks the electrical signal that travels through your heart to make it beat. By clearing the signal pathway of the abnormal tissue, your heart may beat normally again.

Nov. 01, 2011

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