VTACH vs VFIB: The Life-Threatening Arrhythmias You Need to Detect and Treat

Vtach vs Vfib is a critical difference that any rescuer must understand. Both are types of abnormal heart rhythms, and both can be critical to treat rapidly to protect a person’s life. When either type of arrhythmia occurs, it means there are irregular electrical signals occurring in the lower chambers of the heart, called the ventricles. When this happens, the heart cannot pump normally, and that leads to a lack of blood flowing through the heart to the other organs.

Understanding the difference between Vtach vs Vfib enables rescuers to apply the proper treatment.

Both forms require immediate attention, but the type of treatment may be different from a first responder’s point of view. In this overview of both V fib vs V tach, we break down the difference between both and what steps to take in each situation.

What Is Ventricular Fibrillation?

Ventricular fibrillation, or Vfib or VF, is an irregular, life-threatening cardiac arrhythmia that occurs in the ventricular myocardium. Instead of the coordinated contraction necessary, the ventricular myocardium experiences a high-frequency and disorganized excitation. The result of this is the heart’s inability to pump blood through the body effectively.

Data noted by Medscape shares that outside of a hospital setting, 65% to 85% of people in cardiac arrest will have VF identified as the initial irregular rhythm. It is critical to note that, within just minutes, if V fib is not treated, it leads to death.

Thanks to the more commonly available community-based emergency rescue systems, including automatic external defibrillators (AEDs), there is an increase in the number of people who survive V fib, yet it is still critical for treatment to be immediate to give a person a chance at living.

Symptoms of Ventricular Fibrillation

Symptoms of those facing ventricular fibrillation will be essential to see right away so that treatment is provided efficiently. Common initial symptoms include:

• Lightheadedness or dizziness
• Fatigue
• Palpitations, feelings of fluttering or pounding in the chest
• Fainting
• Shortness of breath
• Chest pain and pressure

In some people, there are no external symptoms. A person may experience no symptoms until they pass out because of the lack of blood flow to the brain, at which time the heart stops beating within a matter of minutes.

What Is Happening in the Heart with V Fib and How to Know

One of the steps you need to understand when considering Vtach vs Vfib is what is happening in the heart. In ventricular fibrillation, the lower chambers of the heart contract in an uncoordinated manner, leading to a lack of effective blood flow.

The only way to know for sure what is occurring is through an electrocardiogram. However, a rescuer can take action to determine what is occurring by simply listening or feeling for a heart rate. A person may:

• Lose consciousness
• May be unable to breathe or gasping for air
• A heart rate that is uncoordinated, hard to find, or very fast

In V fib, the electrical signals in the heart are not functioning as they should. In a healthy rhythm, the electrical signals travel from the atria, or upper chambers of the heart, to the lower chambers of the heart. This causes the ventricles to contract, and that contraction pumps blood out into the body.

In V fib, the heart’s electrical impulses are uncoordinated, leading to irregular and rapid electrical signals, causing the heart to quiver instead of pumping.

Common Causes of VFib

Ventricular fibrillation can be caused by two common problems:

• A malfunction of the electrical properties of the heart
• A disruption in the supply of blood to the heart muscle

The dysfunction of the heartbeat creates the risk. Within the heart, the right upper chamber, or right atrium, is the sinus node, a group of cells that work as a pacemaker for the heart’s electrical signals. This starts each heartbeat. The electrical signals move across the atria, and as that happens, it contracts, allowing blood to flow. As the signals arrive at the atrioventricular (AV) node, they slow down, creating a short pause to allow the blood to fill the ventricles. The signals then pass to the ventricles, squeezing the lower chambers and pumping blood to the lungs.

Emergency Management and Treatment of Ventricular Fibrillation

For the layperson, calling 911 and performing CPR is critical to save a person’s life. For the emergency responder, it is critical to follow the cardiac arrest Vfib algorithm for treatment. This process involves:

• Provide CPR, including establishing an airway, providing oxygen, and connecting monitors.
• Evaluate the rhythm to determine Vfib is present.
• Apply an AED device
• Continue CPR for an additional 2 minutes
• Check for heart rate, and if V fib continue care
• Defibrillate a second time, followed by 2 minutes of CRP
• If VF continues, utilize epinephrine 1 mg every 3 to 5 minutes
• Utilize amiodaron or lidocaine for treatment
• Provide post-cardiac arrest care or start the process over

What Is Ventricular Tachycardia?

Ventricular tachycardia, VT, or V tach, is an irregular heartbeat that occurs in the lower chambers of the heart. In most people, a healthy heart rate is between 60 and 100 times a minute at rest. In a person with ventricular tachycardia, the heart beats faster, generally at 100 beats or more per minute.

When the heart rate is too fast, it can cause limitations on the heart’s ability to pump enough blood to the rest of the body. This is because there is not enough blood filling the ventricle before the next contraction occurs. This can lead to a person passing out.

The body can sustain VT for some time, though not usually without difficulty. In some situations, V-tach is a life-threatening conditions, especially if it lasts for more than a few seconds. This is dependent on the speed of the heart. Sometimes, when the heart is in V-tach for too long, or at too fast of a rapid, this can cause all heart activity to stop, called sudden cardiac arrest.

Symptoms of Ventricular Tachycardia

In the initial moments of this condition, it is likely that a person will remain conscious, and depending on how long it occurs and the rate of speed, complications may continue. Most people will have symptoms such as:

• Chest pain
• Dizziness
• Pounding heart rate, called palpitations
• Lightheadedness
• Shortness of breath

There are two key forms:

• Nonsustained V-tach: This tends to stop within 30 seconds. These brief moments often do not cause symptoms.
• Sustained V-tach: This lasts longer than 30 seconds and can lead to serious health complications without treatment.

A person who faints loses consciousness, or experiences cardiac arrest could be suffering from sustained Vtach.

Common Causes of V-tach

Most of the time, the common causes of Vtach occur when there is a malfunction in the heart’s electrical signaling processes. This causes the heart to beat too quickly. When the lower chambers cannot fill with enough blood or squeeze the heart effectively, this can lead to complications. Many factors can contribute to V-tach occurring, including:

• Lack of blood flow to the heart muscle due to coronary artery disease
• Any condition that causes scarring to the heart tissue, called structural heart disease
• Side effects of medications
• Prior heart attacks
• Long QT syndrome and other birth defects
• Changes in mineral levels, including potassium, sodium, calcium, and magnesium
• Use of stimulant drugs, including methamphetamine and cocaine

Management and Treatment of V-Fib

As with any other heart irregularity, the only way to truly have a diagnosis of what is occurring is to utilize an electrocardiogram or halter monitor and to pick up the changes in heart rate over time. Other tests, including an echocardiogram, chest x‐rays, cardiac MRI, or cardiac CT can also provide insight into any damage to the heart’s muscle that could be causing this to occur.

For the emergency responder or rescuer working to save a person’s life, the following steps are taken according to the cardiac arrest VTach algorithm:

• Provide CPR, including establishing an airway, providing oxygen, and connecting monitors.
• Evaluate the rhythm to determine V-tach is present.
• Apply an AED device if so, defibrillate
• Continue CPR for an additional 2 minutes
• Check for heart rate, and if is still v tach continue care
• Defibrillate a second time, followed by 2 minutes of CRP
• If VT continues, utilize epinephrine 1 mg for every 3 to 5 minutes
• Utilize amiodarone or lidocaine for treatment
• Provide post‐cardiac arrest care if the person’s rhythm stabilizes or symptoms subside or start the process over

In all situations, a rapid heart rate needs to be treated quickly. Getting the person to the hospital so that emergency care can be provided is, nearly always critical to creating an opportunity for a person to survive.

What Is the Vtach vs VFib Difference?

The difference between Vtach and Vfib has to do with the function of the heart.

• What is ventricular tachycardia? It is an instance in which the heart rate is above 100 beats per minute, often sustained for longer than 30 seconds. The heart is pumping blood, but at a very rapid pace.
• What is ventricular fibrillation? The heart is not pumping blood because it is not squeezing, but instead, it is quivering due to sustained irregular heartbeats, often very fast.

In Vtach vs Vfib, the main difference is that the ventricles in VF are not contracting properly but quivering instead. This makes it impossible for the heart to pump blood properly, causing sudden cardiac arrest and death. VT can be sustained for some time, but is detected when there are three or more consecutive beats of 100 beats per minute or more.

A ventricular tachycardia ECG will have a notable, controlled rhythm. A ventricular fibrillation ECG will have an uncoordinated, irregular heart rate.

Diagnostics with an ECG

Vtach vs Vfib ECG

In both types of ventricular arrhythmias benefit from an ECG. An electrocardiogram (ECG) provides a way for responders to tell the difference in a person’s heart rate. In comparing a Vtach vs Vfib ECG, consider the ventricular contractions. If they are uncoordinated, that is VF. By contrast, in a Vfib vs Vtach ECG, if the beats are coordinated, but they are very fast, that is VT.

Frequently Asked Questions

What is idioventricular rhythm?

Another condition that may be detected is idioventricular rhythm, which is a heart rate detected in the ventricles that is less than 50 beats per minute with the absence of P waves and with a prolonged QRS interval.

What is monomorphic ventricular tachycardia?

Another type of irregular heart rate is monomorphic ventricular tachycardia, which happens when the lower chambers of the heart beat very dangerously fast. A person with MVT, as it is known, must be treated with synchronized direct current (DC) cardioversion immediately to save their life. This typically starts with a dose of 100 J. Any unstable polymorphic VT must be treated with defibrillation.

What is polymorphic Vtach vs Vfib?

A polymorphic Vtach vs Vfib difference can be difficult to detect initially. In polymorphic ventricular tachycardia, malignant ventricular tachyarrhythmia is present with changing QRS patterns. These may terminate spontaneously in some situations.

What is the ventricular tachycardia Vfib vs Vtach long‐term treatment option?

When it comes to Vtach vs Vfib, one of the ways these conditions result in is the need for monitoring and medication. Most often, a cardioversion can be done to restore normal rhythm as a first step. From there, studies are likely conducted to determine the underlying cause of the concern, such as a structural abnormality. Treatment through ablation, the use of an internal defibrillator, and additional medication management may be part of the initial treatment plan.

Learning How to Save a Person’s Life

If you are asking questions such as “What is tachycardia?” you or someone you know may be facing an increased risk of cardiac arrest. In those who have these conditions, treatment is critical, but the first step is getting them to the hospital for care.

Recognizing when ventricular arrhythmia is occurring is the first critical step, and often patients only have a matter of minutes for treatment to occur. That is why it is critical for anyone to have proper CPR training.

If you have not done so yet, now is the ideal time to complete your Basic Life Support (BLS) training or complete your ACLS certification. Doing so could mean you have the unique opportunity to save a person’s life.

You can learn more about the options available to you to obtain your education and certification, with fully online programs, at Advanced Medical Certification. Take the time to learn how you can save someone’s life. Obtain your education and training online and get certified.