V-Fib: What it is and how to battle it

V-fib, VF, Ventricle Fibrillation. All these terms mean the same thing. A lethal rhythm that, if left untreated, will result in death. With quick action and a prepared rescuer, we can try to prevent death and hopefully, save a life. First lets explain what Vfib is.

Ventricle Fibrillation

Medical: Cardiac muscle of the heart is contracting uncoordinatedly in the ventricles. This produces a quiver. It is identified as “irregularly irregular”, meaning there is no predicability in the heart rhythm on an ECG. During Ventricle Fibrillation, a pulse will not be able to be palpated and electrical intervention will be needed to correct the problem. If the rhythm in not defibrillated, it will degrade into asystole.

Non-medical: In V-Fib, the heart is basically having a seizure, producing no blood flow. This patient is dead. If the patient is talking to you or moving, they are not in VFib, check the monitor.

 Course VfibCourse V-Fib is easily identified

fine v-fibFine V-Fib is not as easy to identify


Medical: Ventricle Fibrillation can be identified by it’s disorganized, chaotic and turbulent activity on an ECG. The ECG deflections will constantly change direction and shape. Typically, VF occurs in unhealthy hearts with ischemic heart disease (note this is not the only cause though).

Non-medical: V-fib looks like static on an ECG. It is irregularly-irregular. The rhythm’s QRS complexes are wide and tall or wide and short. Wide is the key. In VF, the heart is basically having a seizure. Think of an ECG of a patient having a seizure or moving around would look like. Remember, in VF, THIS PERSON IS DEAD. If they are moving, talking or breathing, they are not in Ventrical Fibrillation.

V-Fib Treatment

The ACLS Algorithm per the 2010 AHA guidelines is:
ventricular fibrillation algorithm

This algorithm can overwhelm a lot of people. An easy way to remember all of this is:
1) CPR – If someone does not have a pulse, they need to have CPR started on them immediately
2) Shock, Shock, Drug, Shock, Drug, Shock, Drug, Shock….

That’s it. That’s the most simple breakdown of VF treatment. If you want to get complicated it would become:

Shock, Shock, Epi, Shock, Amiodarone, Shock, Epi, Shock, Amiodarone, Shock, Epi, Shock, Epi, Shock, Epi….

Now this treatment can get more tricky and starts to get some medicine involved when we look for the H’s and T’s (the underlying causes of the cardiac arrest). However, following the Shock, Drug treatment described as above, will allow you to go on autopilot until more experience providers can arrive.

Be sure to look at our video section for an example of V-fib.

To learn how to treat V-fib, sign up for an ACLS Course with us today!