Overview
Definition
A chaotic, disorganized electrical activity of the ventricles resulting in absent mechanical contraction (cardiac arrest).
Epidemiology
The most common initial rhythm in out-of-hospital sudden cardiac arrest.
Etiology & Risk Factors
- Acute Myocardial Infarction / Ischemia (most common)
- Untreated Ventricular Tachycardia
- Electrolyte derangements
- Electrocution
- Brugada Syndrome
Clinical Symptoms
- Unresponsiveness
- Pulselessness
- Agonal breathing or apnea
- Sudden collapse
Clinical Approach
Diagnosis
- ECG/Monitor: Completely disorganized, irregular, chaotic waveforms of varying amplitude with no identifiable QRS complexes
Management
- Immediate high-quality CPR
- Early Defibrillation (shockable rhythm)
- Epinephrine 1mg IV every 3-5 mins
- Amiodarone 300mg IV push for refractory VFib
- Identify and treat reversible causes (H's and T's)
Complications
- Death
- Anoxic brain injury (if resuscitation is prolonged/delayed)
- Post-cardiac arrest syndrome