The result of a successful defibrillation is asystole. The defibrillator is designed to send a large dose of DC energy through the bulk of the myocardium producing immediate and simultaneous stimulation of every muscle cell at the same time. The defibrillator does not “jump start” the heart back into a normal rhythm. The most effective treatment available to terminate ventricular fibrillation is with the use of a defibrillator. The chaotic electrical storm of ventricular fibrillation continues despite CPR and must be addressed as well. Unfortunately, CPR alone will not be enough to save this patient. This generates suboptimal, but necessary coronary blood flow to slow the accumulation of the metabolic waste and replenish needed chemical assets. The only viable treatment to mitigate this terrible situation is immediate, hard, fast, deep, mechanically effective CPR. This fibrillating heart is quivering and contracting in a frenzied but uncoordinated way, using up all available resources (like oxygen, electrolytes, and energy substrates), but without coronary blood flow, these resources are not replenished and the waste products are not eliminated. This chaos must be terminated by an outside source: the defibrillator. There is no way for the heart to recover from this life-threatening state by itself. Coordinated muscular contractions stop and there is no cardiac output. The fibrillating heart is overwhelmed by the chaotic electrical storm of ventricular fibrillation. The heart’s electrical system is in a state of extreme chaos.The heart begins to poison its local environment with this accumulated byproduct. Coronary arterial perfusion ceases, leaving no way to evacuate the toxic wastes and acid. The myocardial tissue is hyperstimulated in early ventricular fibrillation producing copious waste and localized acidosis. The fibrillating heart is working furiously but futilely. ![]() There are two important facts to understand about ventricular fibrillation in order to respond to this life-threatening emergency appropriately: Ventricular fibrillation is the most common rhythm displayed by the adult patient in the early minutes of cardiac arrest.
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