Fibrilación ventricular: tratamiento, causas, síntomas, diagnóstico y prevención

La fibrilación ventricular (FV) es un estado de actividad ventricular caótica, provocado por el disparo aleatorio de múltiples focos ectópicos, debido probablemente a un mecanismo complejo de reentrada. Puede aparecer a consecuencia de la degeneración de una TV y muy a menudo aparece en el contexto de un IAM. La arritmia provoca una actividad aleatoria e inefectiva de los ventrículos, que impide una circulación sanguínea efectiva. La muerte se produce en cuestión de minutos si no se inicia una resucitación adecuada. El ECG (fig. 77.4d) muestra unas oscilaciones erráticas, sin complejo reconocible; si tienen una amplitud de más de 1 mm se denomina FV “imprecisa” y se considera más tratable mediante la desfibrilación que la FV “fina”.

El tratamiento se debería iniciar de inmediato mediante el uso de maniobras de resucitación cardiopulmonar, tal y como se describe en los protocolos de soporte vital básico (SVB) y de SVA. Se debería efectuar el traslado al hospital para seguir el tratamiento definitivo tan pronto como fuera posible. Los pacientes que sobreviven a un episodio de fibrilación ventricular son candidatos a la implantación de un desfibrilador cardíaco.

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