Internal Medicine

0521779407-22 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:23

Ventricular Fibrillation (VF) 1525

tests

■Basic Tests

➣12-lead ECG:

➣Fast, irregular, poorly organized QRS-T complexes with varying

morphology and amplitude

■Specific Diagnostic Test

➣none

differential diagnosis

■Other causes of sudden collapse such as pulmonary embolism,

seizure from neurological events and diabetic coma.

management

What to Do First

■Immediate cardiopulmonary resuscitation: begin Advanced Cardiac

Life Support protocol

General Measures

■Correction of electrolyte imbalance. Magnesium replacement. Eval-

uation and treatment for acute coronary syndrome or myocardial

infarction.

specific therapy

■Unsynchronous external DC shock with 360 J.

■Immediate infusion of IV amiodarone

Side Effects & Contraindications

■Drugs: proarrhythmia; heart block; CPR: rib fractures. Prolonged car-

diac arrest: stroke, coma, death.

follow-up

■Treatment of underlying diseases. Coronary angiography with revas-

cularization. Implantation of an internal cardioverter defibrillator if

no reversible causes are identified or VF occurs more than 24 hours

after an acute infarction.

complications and prognosis

■Survival related to underlying diseases and improved with ICD

therapy.