If it looks like ventricular fibrillation (VF), shock

Ventricular fibrillation. We know it as the most important shockable cardiac arrest rhythm.

In ventricular fibrillation, or VF, the ventricles of the heart suddenly attempt to contract at rates of up to 500 beats per minute. This irregular electrical activity means the ventricles can’t contract as they should, so the heart is no longer an effective pump.

Without rapid advanced life support, degeneration into asystole is inevitable.

Clinically, sometimes the phrases ‘fine’ and ‘coarse’ are used when talking about VF; following national media coverage of a very sad case in another ambulance service, staff contacted us to ask the Trust’s stance on fine VF – do we shock it?

The simple response is: if you think it’s VF, shock. If you think it’s asytole, don’t shock.

The terms ‘fine’ and ‘coarse’ can be confusing; the Resuscitation Council Guidelines don’t actually distinguish between fine and coarse, but simply class ‘VF’ as shockable. You can find guidance on the treatment of shockable and non-shockable rhythms on the Council website, should you want to refresh your knowledge.

If you have any questions, you can contact our area clinical leads team at any time via clinical.leads@eastamb.nhs.uk.

Published 16th March, 2017