What Is Ventricular Fibrillation (VFib)?
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Medically reviewed by Christopher Lee, MD
Ventricular fibrillation—more commonly known as VFib—is a life-threatening heart rhythm problem that occurs when your heart's chambers aren't able to pump blood effectively. Normally, the electrical system in the heart delivers regular signals to your heart, which allow your heart muscle to contract and pump blood to the rest of your body.
But when you develop VFib, the electrical system sends rapid and erratic signals to your heart, which makes it difficult for blood to pump out of your heart properly. Without proper blood flow to other organs in your body (such as your brain), you can experience a loss of consciousness and collapse. This is known as sudden cardiac arrest, which is a potentially fatal condition that requires immediate CPR to prevent death.
Symptoms
In most cases, it's really difficult to recognize if VFib is happening to you. That's because it happens so rapidly and leads to collapse. However, it's important to recognize the signs, as you may be able to help someone else experiencing the condition. The most common signs of VFib include:
Sudden collapse
Inability to wake up with shouting or shaking
No pulse
Difficulty breathing
Cold and bluish-colored skin
People who have VFib are also at an increased risk of cardiac arrest. Before cardiac arrest, someone may complain of the following symptoms before collapsing:
Lightheadedness or dizziness
Heart palpitations
Causes
In VFib, the heart's electrical system becomes dysfunctional and gives rapid and disorganized signals for the heart muscle to contract. In response, your heart muscle quivers instead of contracting normally, which makes it difficult for your heart to pump out blood to the rest of your organs. This leads to a lack of oxygen to the brain (medically known as hypoxia) which causes you to collapse. Unfortunately, death can occur within minutes if you don't receive treatment.
There are many potential causes of VFib, including
Ischemia, or lack of blood flow to the heart, which typically occurs during a heart attack
Cardiomyopathy, or disease of the heart muscle
Scarring of the heart muscle, such as from a previous heart attack
Electrolyte abnormalities, such as high levels of potassium in the blood (known as hyperkalemia)
Taking certain medications
Getting electrocuted or being hit by lightning
A sudden forceful trauma directly to the chest, known as commotio cordis
Risk Factors for VFib
Certain people are at higher risk for VFib. This includes people with certain heart diseases such as:
Coronary artery disease (occurs when your heart's blood vessels become narrow and block blood flow)
Cardiomyopathy or heart failure
Congenital heart disease (heart abnormalities that you are born with)
Certain genetic conditions that can cause an irregular heartbeat, such as long QT syndrome and Brugada syndrome
Diagnosis
A healthcare provider can most accurately diagnose VFib with an electrocardiogram (ECG or EKG), which is a test that shows the electrical activity occurring in the heart. If cardiac arrest occurs outside of a hospital, placing an automated external defibrillator (AED) can diagnose and treat the dangerous rhythm. AEDs are emergency equipment that can be found hanging on the wall in many public places like airports, libraries, office buildings, and gyms.
If a person survives an episode of VFib, their healthcare provider will perform several other tests in the hospital to determine the underlying cause of their episode. These may include:
Coronary angiography: Takes a look at the coronary arteries (heart's blood vessels) that feed the heart to look for any blockages in blood flow
Cardiac imaging: May include an echocardiogram, computed tomography (CT scan), or magnetic resonance imaging (MRI) to look at the heart's structure and function
Genetic testing: Looks for specific underlying genetic conditions
Blood tests: Assesses levels of electrolytes and heart enzymes
Electrophysiology (EP) study: A procedure that uses catheters in the heart to evaluate and treat arrhythmias (irregular heartbeats)
Treatment
The goal of treatment in VFib is to restore your heart's normal rhythm to return proper blood circulation in your body. If someone experiences cardiac arrest, immediate treatment with cardiopulmonary resuscitation (CPR) is essential and can be life-saving. The American Heart Association recommends calling 9-1-1 and performing CPR until medical help arrives if you witness someone suddenly collapse.
Related: What Is CPR and How Do You Perform It?
If an AED is available near you, it's best to use the device on someone experiencing cardiac arrest. Most public places should have an AED on the wall. Once you open the AED box, it provides simple verbal instructions on how to use the device. Inside the box, there are stickers to apply to the person's chest. If the AED assesses that the irregular heart rhythm is due to VFIB, the device will give you instructions to press a button on the machine and deliver a shock to the person's body to return the heart to a normal rhythm.
While methods such as CPR or using an AED can be life-saving, it's still essential to receive treatment for the underlying cause of VFib. Your healthcare provider may prescribe medications if your VFib is due to heart failure or electrolyte abnormalities. But, antiarrhythmic medications can also help regulate an abnormal heart rhythm.
Your provider may also recommend some procedures to treat VFib or prevent future episodes. These include:
Coronary angioplasty: A surgery that helps open up blocked arteries in a heart attack
Implantable cardioverter-defibrillator (ICD): Places a device under the skin of your chest to monitor the heart's rhythm and deliver treatment for serious arrhythmias like VFib
Catheter ablation: A procedure that uses catheters to map the electrical system of the heart and either burn or freeze specific portions to create scar tissue to prevent VFib from occurring
How to Prevent VFib
It's not always possible to prevent VFib. However, keeping your heart healthy can help prevent some of the heart diseases that lead to VFib, such as coronary artery disease. Your primary care provider can estimate your risk of heart disease and make specific recommendations. They may recommend making the following lifestyle adjustments to lower your risk of VFib:
Keep your cholesterol and blood sugar levels in check
Monitor your blood pressure regularly
Getting regular physical activity—ideally 30 minutes a day of moderate exercise
Eating a heart-healthy diet that is rich in fruits, vegetables, beans, whole grains, and fish
Limiting foods that are high in salt, sugar, and saturated and trans fats
Avoiding excess alcohol intake
A Quick Review
VFib is a type of arrhythmia or irregular heartbeat that is the most common cause of sudden cardiac arrest. Several underlying conditions can cause VFib, such as coronary artery disease and heart failure. In VFib, your heart can't pump blood normally, and the lack of blood flow to the brain can lead to collapse and death within minutes. Immediate treatment with CPR is essential and can be life-saving.
Frequently Asked Questions
What is the difference between AFib and VFib?
Fibrillation is a word to describe rapid and erratic contractions of the heart muscle. In AFib, the problem is in the upper chambers (atria) of the heart. AFib can cause high heart rates and increase the risk of stroke, but blood flow out of the heart to the body is preserved. In VFib, on the other hand, the heart's main pumping chambers, the ventricles, become affected. Blood can't exit the ventricles normally, so blood flow out of the heart becomes blocked, leading to sudden collapse or death.
Do you need CPR if you go into VFib?
Yes, cardiopulmonary resuscitation (CPR) is essential for people with sudden cardiac arrest due to VFib. If you see someone suddenly collapse and are unable to wake them up, call 9-1-1 and start CPR. Using an automated external defibrillator (AED) can also be life-saving in this situation.
Does VFib require a pacemaker?
Depending on the situation, if someone survives a cardiac arrest due to VFib, their cardiologist may recommend the placement of a special device called an implantable cardioverter-defibrillator (ICD). While ICDs are similar to pacemakers, they have the special capability of delivering an electrical shock to stop VFib and other life-threatening arrhythmias from happening.
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