Our Summary

Ventricular fibrillation (VF) is a common reason for sudden heart failure and death, but right now, there’s no cure. The treatments that exist focus on preventing this sudden heart failure, such as implanting a device that can correct abnormal heart rhythms or using medication to control heart rhythm.

There has been significant progress in understanding what triggers VF and how to target these triggers using advanced techniques, such as detailed mapping of the heart and a procedure called ablation (which scars or destroys tissue that’s causing abnormal heart rhythms). There’s also been progress in using the body’s own nervous system to control VF.

However, we still don’t completely understand what maintains VF. This paper reviews the current knowledge about the basic mechanisms behind VF and discusses the role of catheter ablation (a procedure that can correct heart rhythm problems) in treating patients with VF.

FAQs

  1. What is ventricular fibrillation and how is it commonly treated?
  2. What is the current role of catheter ablation in treating patients with ventricular fibrillation?
  3. What are the basic mechanisms of ventricular fibrillation according to current evidence?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac ablation is to follow their post-procedure care instructions carefully, including taking any prescribed medications, attending follow-up appointments, and avoiding strenuous activities as recommended. It is also important to communicate any unusual symptoms or concerns to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for cardiac ablation are those who have recurrent, symptomatic, drug-refractory ventricular arrhythmias, such as ventricular fibrillation (VF). These patients may have a history of sudden cardiac death or have an increased risk for sudden cardiac death. Additionally, patients with structural heart disease, such as coronary artery disease, cardiomyopathy, or valvular heart disease, may also be considered for cardiac ablation. Other factors that may contribute to the decision for cardiac ablation include the presence of genetic disorders associated with arrhythmias, as well as the patient’s overall health and willingness to undergo the procedure.

Timeline

  • Before cardiac ablation:
  1. Patient may experience symptoms such as palpitations, shortness of breath, dizziness, or fainting episodes.
  2. Patient undergoes diagnostic tests such as an electrocardiogram (ECG), echocardiogram, and possibly a cardiac MRI to assess the underlying heart rhythm disorder.
  3. If a diagnosis of ventricular fibrillation (VF) is confirmed, the patient may be prescribed medications to control the heart rhythm and prevent sudden cardiac death.
  4. If medications are ineffective or have significant side effects, the patient may be considered for a catheter ablation procedure.
  • After cardiac ablation:
  1. The patient is prepped for the ablation procedure, which involves threading a catheter through a blood vessel to the heart to target and destroy the abnormal heart tissue causing the arrhythmia.
  2. The patient may be under sedation or general anesthesia during the procedure, which typically lasts a few hours.
  3. After the ablation, the patient is monitored closely for any complications and may need to stay in the hospital for observation.
  4. In the days and weeks following the procedure, the patient may experience some chest discomfort, fatigue, and palpitations as the heart heals.
  5. Follow-up appointments with the cardiologist are scheduled to assess the success of the ablation and make any necessary adjustments to medications or further treatments.
  6. With successful ablation, the patient’s symptoms of VF should be significantly reduced or eliminated, and the risk of sudden cardiac death may be greatly reduced.

What to Ask Your Doctor

  1. What is cardiac ablation and how does it work to treat ventricular fibrillation?
  2. Am I a candidate for cardiac ablation as a treatment for ventricular fibrillation?
  3. What are the potential risks and complications associated with cardiac ablation?
  4. What is the success rate of cardiac ablation in treating ventricular fibrillation?
  5. How long is the recovery period after undergoing cardiac ablation?
  6. Will I need to continue taking medication after undergoing cardiac ablation?
  7. Are there any lifestyle changes I should make after undergoing cardiac ablation?
  8. How often will I need to follow up with you after the procedure?
  9. Are there any alternative treatments for ventricular fibrillation that I should consider?
  10. What is the long-term outlook for someone who undergoes cardiac ablation for ventricular fibrillation?

Reference

Authors: Ezzeddine FM, Darlington AM, DeSimone CV, Asirvatham SJ. Journal: Card Electrophysiol Clin. 2022 Dec;14(4):729-742. doi: 10.1016/j.ccep.2022.06.002. Epub 2022 Oct 28. PMID: 36396189