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[[Soubor:Srdce fibrilace komor.png|thumb|Schéma chaoticky vznikajících vzruchů v myokardu srdečních komor při fibrilaci komor.]]
[[File:Heart of ventricular fibrillation.png|thumb|Scheme of chaotically arising excitations in the myocardium of the heart chambers during ventricular fibrillation.]]
'''Fibrilace komor''' (FK) a '''rychlá komorová tachykardie''' (KT) patří mezi tzv. maligní [[arytmie]]. Jedná se o [[poruchy srdečního rytmu]], které pacienta urgentně ohrožují na životě (je třeba je neodkladně řešit) a které jsou nejčastější příčinou [[Náhlá srdeční smrt|náhlé srdeční smrti]] (NSS).<ref name="Mlčochová">{{Citace
Ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) belong to the so-called malignant [[arrhythmias]]. These are [[heart rhythm disorders]] that urgently threaten the patient's life (they must be dealt with immediately) and are the most common cause of [[Sudden cardiac death|sudden cardiac death]] (NSS).<ref name="Mlčochová ">{{Quote
| typ = článek
| type = article
| příjmení1 = Mlčochová
| surname1 = Mlčochová
| jméno1 = Hanka
| name1 = Hank
| kolektiv = ano
| collective = yes
| článek = Katetrizační ablace fibrilace komor pomocí eliminace spouštěcí komorové ektopie
| article = Catheter ablation of ventricular fibrillation using elimination of triggering ventricular ectopy
| časopis = Interv Akut Kardiol
| journal = Interv Akut Kardiol
| url = http://www.solen.cz/pdfs/kar/2007/05/02.pdf
| url = http://www.solen.cz/pdfs/kar/2007/05/02.pdf
| rok = 2007
| year = 2007
| ročník = 5
| grade = 5
| svazek = 5
| volume = 5
| strany = 173-176
| pages = 173-176
| issn = 1803-5302
| issn = 1803-5302
}}</ref> Relativně často vzniká komorová fibrilace v rámci akutního infarktu myokardu.
}}</ref> Ventricular fibrillation occurs relatively often as part of an acute myocardial infarction.
 
== Etiology ==
== Etiologie ==
The causes of ventricular fibrillation include:<ref name="Mlčochová"/> <ref name="Haman">{{Citation
Mezi příčiny fibrilace komor řadíme:<ref name="Mlčochová"/> <ref name="Haman">{{Citace
| type = web
| typ = web
| lastname1 = Haman
| příjmení1 = Haman
| name1 = Peter
| jméno1 = Petr
| url = http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor
| url = http://www.ekg.kvalitne.cz/tvorba.htm#Fibrilace%20komor
| name = EKG Learning Site
| název = Výukový web EKG
| subtitle = ECG Basics
| podnázev = Základy EKG
| cited = 2010-11-21
| citováno = 2010-11-21
}}</ref>
}}</ref>
* Organické postižení srdce ('''[[Ischemická choroba srdeční|ICHS]]''' a '''[[infarkt myokardu|IM]]''', [[kardiomyopatie]], srdeční [[amyloidóza]], …),
* Organic heart disease ('''[[Ischemic heart disease|CHD]]''' and '''[[myocardial infarction|MI]]''', [[cardiomyopathy]], cardiac [[amyloidosis]], ... ),
* [[syndrom dlouhého QT intervalu]] (LQTS), [[Brugadův syndrom]],
* [[long QT syndrome]] (LQTS), [[Brugado syndrome]],
* idiopatická fibrilace komor.
* idiopathic ventricular fibrillation.


== Patogeneze ==
== Pathogenesis ==
V případě komorové fibrilace se jednotlivé [[Myokard (histologický preparát, HE)|kardiomyocyty]] srdečních komor kontrahují zcela '''nesynchronizovaně'''. Tyto chaotické a rychlé kontrakce vedou k naprostému '''selhání funkce srdce jakožto pumpy'''. Jelikož srdce nepřečerpává žádnou krev ([[Stanovení srdečního výdeje|minutový výdej srdeční]] je téměř nulový), dochází k vážné '''poruše perfúze''' vitálních orgánů včetně [[mozek|mozku]] (→ ztráta [[Vědomí a jeho poruchy|vědomí]] nastává do 10 s) a bez okamžité [[Základní neodkladná resuscitace|kardiopulmonální resuscitace]] a [[defibrilace]] vede komorová fibrilace ke smrti (za 3–5 minut se rozvíjí irreverzibilní poškození mozku<ref>{{Citace
In the case of ventricular fibrillation, the individual [[Myocardium (histological preparation, HE)|cardiomyocytes]] of the heart chambers contract completely '''unsynchronized'''. These chaotic and rapid contractions lead to a complete '''failure of the heart's function as a pump''. Since the heart is not pumping any blood ([[Determining cardiac output|minute cardiac output]] is almost zero), there is severe '''perfusion failure'''' of vital organs including the [[brain|cerebrum]] (→ loss of [[Consciousness and his disturbance|consciousness]] occurs within 10 s) and without immediate [[Basic emergency resuscitation|cardiopulmonary resuscitation]] and [[defibrillation]], ventricular fibrillation leads to death (irreversible brain damage develops in 3-5 minutes<ref>{ {Citation
| typ = kniha
| type = book
| příjmení1 = Češka
| surname1 = Czech
| jméno1 = Richard
| name1 = Richard
| kolektiv = ano
| collective = yes
| titul = Interna
| title = Intern
| vydání = 1
| issue = 1
| místo = Praha
| place = Prague
| vydavatel = Triton
| publisher = Triton
| rok = 2010
| year = 2010
| rozsah = 855
| range = 855
| strany = 480-481
| pages = 480-481
| isbn = 978-80-7387-423-0
| isbn = 978-80-7387-423-0
}}</ref>).
}}</ref>).


[[File:Ventricular fibrillation video.webm|upright=1.4|náhled|video v angličtině: definice, patogeneze, příznaky a komplikace, diagnostika, léčba]]
[[File:Ventricular fibrillation video.webm|upright=1.4|preview|video in English: definition, pathogenesis, symptoms and complications, diagnosis, treatment]]


Physiologically, a depolarization wave occurs in the [[Cardiac conduction system|SA node]]. In ventricular fibrillation, '''abnormal electrical impulses'' occur directly in the heart's chambers. These abnormal impulses can arise unifocally or multifocally, it can be a reentry mechanism or a combination of these mechanisms.
Physiologically, a depolarization wave occurs in the [[Cardiac conduction system|SA node]]. In ventricular fibrillation, '''abnormal electrical impulses'' occur directly in the heart's chambers. These abnormal impulses can arise unifocally or multifocally, it can be a reentry mechanism or a combination of these mechanisms.

Revision as of 22:23, 5 January 2023

File:Heart of ventricular fibrillation.png
Scheme of chaotically arising excitations in the myocardium of the heart chambers during ventricular fibrillation.

Ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) belong to the so-called malignant arrhythmias. These are heart rhythm disorders that urgently threaten the patient's life (they must be dealt with immediately) and are the most common cause of sudden cardiac death (NSS).[1] Ventricular fibrillation occurs relatively often as part of an acute myocardial infarction.

Etiology

The causes of ventricular fibrillation include:[1] [2]

Pathogenesis

In the case of ventricular fibrillation, the individual cardiomyocytes of the heart chambers contract completely unsynchronized'. These chaotic and rapid contractions lead to a complete failure of the heart's function as a pump. Since the heart is not pumping any blood (minute cardiac output is almost zero), there is severe perfusion failure' of vital organs including the cerebrum (→ loss of consciousness occurs within 10 s) and without immediate cardiopulmonary resuscitation and defibrillation, ventricular fibrillation leads to death (irreversible brain damage develops in 3-5 minutes[3]).

6:21CC

Physiologically, a depolarization wave occurs in the SA node. In ventricular fibrillation, 'abnormal electrical impulses occur directly in the heart's chambers. These abnormal impulses can arise unifocally or multifocally, it can be a reentry mechanism or a combination of these mechanisms.

Ventricular tachycardia, ventricular flutter or early ventricular extrasystole can become ventricular fibrillation.

Clinical manifestation

Clinically, ventricular fibrillation manifests as:[2]

  • loss of consciousness;
  • inaudible heart sounds;
  • non-palpable pulse;
  • immeasurable pressure.

Diagnostics

Ventricular fibrillation - scheme.
File:Lead II rhythm generated ventricular fibrillation VF.JPG
ECG image of ventricular fibrillation.

The diagnosis is based on the ECG.

Individual cardiomyocytes contract completely independently and unsynchronized, therefore we cannot identify any QRS complexes on the ECG. We see irregular waves with a frequency of 300/min and more.

Treatment

  • Treatment consists of immediate initiation of cardiopulmonary resuscitation'' (opinions on precordial beat vary) and external or internal defibrillation as soon as possible.
  • Some types of ventricular fibrillation can be treated with radiofrequency ablation' of focal ventricular ectopy.[1]
  • In primary and secondary prevention, some antiarrhythmic drugs and implantation of an implantable cardioverter-defibrillator (ICD) can be used.


  • Portable manual external defibrillator

    Portable manual external defibrillator

  • Implantable cardioverter-defibrillator

    Implantable cardioverter-defibrillator

  • Scheme of the established ICD

    Scheme of the established ICD

  • X-ray image of an implanted ICD

    X-ray image of an implanted ICD

Links

Related Articles

External links

References

  1. ↑ Jump up to: a b c
    „ {{{1}}} “
  2. ↑ Jump up to: a b {{#switch: web |book = Incomplete publication citation. Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.  |collection = Incomplete citation of contribution in proceedings. . Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. {{ #if: |978-80-7262-438-6} } |article = Incomplete article citation.  . EKG Learning Site. also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.  |web = Incomplete site citation. . EKG Learning Site : ECG Basics [online]. [cit. 2010-11-21]. <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. |cd = Incomplete carrier citation. . EKG Learning Site : ECG Basics [CD/DVD]. [cit. 2010-11-21].  |db = Incomplete database citation. EKG Learning Site : ECG Basics [database]. [cit. 2010-11-21]. <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. |corporate_literature = Incomplete citation of company literature. . Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. legislative_document = Incomplete citation of legislative document.  Also available from URL <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.
  3. ↑ { {Citation | type = book | surname1 = Czech | name1 = Richard | collective = yes | title = Intern | issue = 1 | place = Prague | publisher = Triton | year = 2010 | range = 855 | pages = 480-481 | isbn = 978-80-7387-423-0 }}

References

  • {{#switch: book

|book = 

  Incomplete publication citation. . ECG briefly, clearly, clearly. Grada, 2005. 149 s. 978-80-7262-438-6.

|collection = 

  Incomplete citation of contribution in proceedings. . ECG briefly, clearly, clearly. Grada, 2005. 149 s. {{
  #if: 80-247-0960-0 |978-80-7262-438-6} }
  |article = 
  Incomplete article citation.  . 2005, year 2005, 

|web = 

  Incomplete site citation. . Grada, ©2005. 

|cd = 

  Incomplete carrier citation. . Grada, ©2005. 

|db = 

  Incomplete database citation. Grada, ©2005. 

|corporate_literature = 

  . ECG briefly, clearly, clearly. Grada, 2005. 149 s. 978-80-7262-438-6} }
  • {{#switch: web

|book = 

  Incomplete publication citation. Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. 

|collection = 

  Incomplete citation of contribution in proceedings. . Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. {{
  #if:  |978-80-7262-438-6} }
  |article = 
  Incomplete article citation.  . EKG Learning Site. also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. 

|web = 

  Incomplete site citation. . EKG Learning Site : ECG Basics [online]. [cit. 2010-11-19]. <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.

|cd = 

  Incomplete carrier citation. . EKG Learning Site : ECG Basics [CD/DVD]. [cit. 2010-11-19]. 

|db = 

  Incomplete database citation. EKG Learning Site : ECG Basics [database]. [cit. 2010-11-19]. <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.

|corporate_literature = 

  Incomplete citation of company literature. . Also available from <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>. legislative_document = 
  Incomplete citation of legislative document.  Also available from URL <http://www.ekg.kvalitne.cz/tvorba.htm#Fibrillation%20komor>.
  • HELLO, Robert. Cardiology ring. III. internal clinic of VFN and 1st Faculty of Medicine of the University of Prague in Prague, 2009.
  • VILIKUS, Zdeněk. Interpretation of ECG at rest and during exercise. Institute of Physical Education Medicine 1. LF UK and VFN; 2010.
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