Atrial Fibrillation (AFib) vs. Ventricular Fibrillation (VFib)

Atrial fibrillation (AFib) is a type of abnormal heart rhythm (arrhythmia), usually with a very fast heart rate, that is caused by irregular contractions of the upper chambers of the heart (the atria).

Ventricular fibrillation (VFib), like atrial fibrillation, also is a type of abnormal heart rhythm in which the heart rate is irregular, but is usually fast due to irregular contractions of the lower chambers of the heart (ventricles).

Atrial fibrillation and ventricular fibrillation are caused by similar problems with the heart, but they are not the same type of problem.

Electrical impulses generated within the heart tissue cause both heart conditions, but the electrical impulses arise in different areas of the heart. Irregular electrical impulses occur from multiple sites in the atria to cause atrial fibrillation, while irregular electrical impulses occur mainly in the ventricles to cause ventricular fibrillation.

Although both atrial fibrillation and ventricular fibrillation may cause serious medical problems with a patient.

Ventricular fibrillation, especially if it is sustained, is considered far more serious as the patient can quickly develop "sudden death" or "cardiac arrest," and die.

Ventricular fibrillation does not allow the heart to pump enough blood to the arteries, and therefore to the body's vital organs, because the heart's ventricles are quivering (fibrillation), and they cannot pump blood (contract or squeeze). Ventricular fibrillation is considered a medical emergency.

AFib vs. VFib

• AFib also is referred to as "supraventricular tachycardia" because the problem occurs above the ventricles. In AFib, the abnormal heart rhythm is due to irregular electrical activity in the upper chambers of the heart muscles, the atria, mainly the right atrium. Usually, it results in a fast and irregular heartbeat.
• VFib occurs when the electrical signal is irregular within the lower chamber heart muscles (ventricles). The heart is then unable to effectively beat or pump blood, which results in sudden cardiac death if the person is not treated immediately.

ECGs of a Normal, Atrial Fibrillation, and Ventricular Fibrillation

• Normal ECG wave pattern strip of a normal heartbeat
• Enlargement of a normal ECG strip showing PQRST intervals in a normal heartbeat
• ECG EKG wave strip of Atrial Fibrillation (AFib)
• ECG wave pattern strip for atrial Ventricular Fibrillation (VFib)

• Both ventricular and atrial fibrillation may cause dizziness, nausea, shortness of breath, and chest pain.
• However, some people with VFib may only experience these symptoms an hour or so before a sudden collapse.
• People with AFib may experience the signs and symptoms for various periods of time (minutes, hours, days) without a sudden collapse.

Ventricular fibrillation usually has a very short time frame of profound signs and symptoms such as collapse, loss of consciousness, and either a weak, erratic pulse or no pulse at all.

In contrast, atrial fibrillation can produce a number of symptoms that can occur over prolonged periods, for example:

• Irregular and rapid heartbeat or pulse
• Weakness
• Dizziness
• Fatigue (especially with any exercise)
• Feeling like you’re going to faint
• Occasional confusion
• Thumping or fluttering in the chest

Ventricular Fibrillation Treatment and Management

VFib is a medical emergency. It must be treated immediately if the person is to survive.

Cardiopulmonary resuscitation (CPR) needs to be started immediately to help maintain some blood flow to the body.

• As soon as possible, the delivery of electrical shock (defibrillation) needs to be done to attempt to allow the heart to resume a normal rhythm.
• Some public places like shopping malls and public buildings may have AEDs, or automatic external defibrillators available for such emergencies.
• Individuals that survive ventricular fibrillation will likely need medications and an implantable cardioverter-defibrillator (ICD), and evaluation for surgical stint placement, surgical coronary angioplasty, or bypass surgery.

Atrial Fibrillation Treatment and Management

AFib may be treated with medication, simple procedures, or surgery.

• Medications like beta blockers and calcium channel blockers (CCBs) help improve symptoms, but do not cure abnormal electrical impulses. Moreover, because of the chance of developing blood clots is increased with AFib, anticoagulants usually are prescribed.
• Simple lifestyle changes, such as avoiding foods that may trigger AFib (for example, caffeine containing liquids like coffee), are helpful.
• Some people with AFib respond well procedures like electro-cardioversion. This technique is used to reset the heartbeat to normal, but uses far less electricity than is used for fibrillation.
• Ablation techniques (for example, radiofrequency ablation, laser ablation or cryo- ablation) can be used to diminish or destroy areas in the atria that function as sources for abnormal electrical signals.
• Some individuals may benefit from surgery to implant a pacemaker, which generates an electrical signal to keep a steady rhythm in the heart, or to sense when the heartbeat is too fast or too slow, and then provide appropriate electrical intervention.

Reducing the risk of AFib and VFib can be achieved with the following lifestyle adjustments:

• regular physical activity,
• heart-healthy diet,
• managing high blood pressure, and
• avoiding alcohol and stimulants like caffeine and/or nicotine.

You can reduce recurrent episodes of AFib by controlling your blood pressure and by taking prescribed medications for underlying medical conditions (for example, thyroid disease, diabetes, obesity) you have.

In VFib, an implanted device (ICD) can automatically defibrillate the heart if it detects the arrhythmia. However, it does not prevent the condition. The device is only designed to automatically stop intricate fibrillation after it occurs.

The outlook for a person with untreated ventricular fibrillation is poor. The individual usually will die within a few minutes if untreated.

• Even if VFib is treated, survival rates at best range from about 20%-35%.
• Rates are higher if the person is taken to the hospital immediately and receives medical care.
• Many people that survive ventricular fibrillation have some level of neurologic damage.

In general, individuals with atrial fibrillation, if appropriately treated, can live a relatively normal lifespan, depending on other heart disease problems. However, the condition increases the chance of having a stroke and/or heart failure, especially if not treated.

Atrial fibrillation and ventricular fibrillation are written in many different ways in literature. Some examples include:

• Ventricular fibrillation, Ventricular Fibrillation, vfib, Vfib, VF, vfib, v-fib
• Atrial fibrillation, Atrial Fibrillation, afib, Afib, afib, a-fib, and AF, sometimes atrial fibrillation is referred to as “holiday heart syndrome,” as excess short term use of alcohol can set cause the condition.

Note: Atrial fibrillation’s designation as “AF” is easily confused with another heart arrhythmia, atrial flutter. Unfortunately, atrial flutter also is abbreviated or written as “AF.” Atrial flutter is a heart arrhythmia closely related to atrial fibrillation.