Ventricular fibrillation medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In the event of cardiac arrest due to ventricular fibrillation, the immediate implementation of ACLS guidelines is indicated. When a sudden cardiac arrest occurs, immediate CPR is a vital link in the chain of survival. Another important link is early defibrillation, which has improved greatly with the widespread availability of AEDs. It often starts with analysing patient's heart rhythms with a manual defibrillator.

Medical Therapy

Defibrillation

Electric Defibrillator

The condition can often be reversed by the electric discharge of direct current from a defibrillator. Although a defibrillator is designed to correct the problem, and its effects can be dramatic, it is not always successful.

Implantable Electric Defibrillator

In patients at high risk of ventricular fibrillation, the use of an implantable cardioverter defibrillator has been shown to be beneficial.

Precordial Thump

If no defibrillator is available, a precordial thump can be delivered at the onset of VF for a small chance to regain cardiac function. However, research has shown that the precordial thump releases no more than 30 joules of energy. This is far less than the 200–360 J typically used to bring about normal sinus rhythm. Consequently, in the hospital setting, this treatment is not used.

Antiarrhythmic Agents

Antiarrhythmic agents like amiodarone or lidocaine can help, but, unlike atrial fibrillation, ventricular fibrillation rarely reverses spontaneously in large adult mammals. Drug therapy with antiarrhythmic agents in ventricular fibrillation does not replace defibrillation and is not the first priority, but is sometimes needed in cases where initial defibrillation attempts are not successful.

Contraindicated medications

Ventricular fibrillatioins is considered an absolute contraindication to the use of the following medications:

References

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