Because ventricular fibrillation (VF) is a true cardiac emergency, immediate and appropriate treatment is crucial. Every minute counts to avoid sudden cardiac death. The best treatment for the patient is called defibrillation. Defibrillation involves an electrical shock that is given to either “reset” the heart's rhythm, or to “restart” the heart of a patient who has gone into cardiac arrest. Recent studies suggest that the survival rate for VF is as high as 90 percent if defibrillation occurs within one minute of onset. With each minute that passes, the chance for survival decreases by 10 percent. At four minutes, serious damage begins to occur in vital organs, including the brain, and the risk of long-term disability increases dramatically.

There are two strategies for using defibrillation in an emergency. If the patient is in the hospital, physicians can program a manual defibrillator to deliver high intensity electrical charges through two paddles placed on the patient’s chest, restoring normal heart rhythm and restarting the flow of blood.

In a non-medical location like a mall or at home, an automatic external defibrillator (AED) can be used. People do not need any medical training to use AEDs, and their widespread use is recommended by the American Heart Association (AHA). 

AEDs are becoming more common in ambulances and fire rescue vehicles, as well as in places that are cut off from traditional emergency assistance (e.g., airplanes). AEDs are also available in some public gathering places, such as stadiums, shopping malls and golf courses, and have been approved for home use. AEDs can be used on both adults and children.

Giving cardiopulmonary resuscitation (CPR) is one way to “buy time” for someone experiencing VF. CPR can provide oxygen to organs, but it cannot restore the heart rhythm of the patient. Defibrillation can. The AHA recommends immediate CPR, with the first shock by an AED within three to five minutes.

Treatments are available for people who have survived ventricular fibrillation (VF) or cardiac arrest. These treatments may involve controlling an underlying condition such as high blood pressure (hypertension) or coronary artery disease.

In almost all cases, patients who have survived a cardiac arrest require cardiac catheterization and an electrophysiology study. In addition, the most common long-term treatment is implantation of an implantable cardioverter defibrillator (ICD) in the patient’s chest. This device monitors the patient’s heart rhythm and, if necessary, can administer a shock to correct abnormal rhythms.

Medications such as antiarrhythmics may also be prescribed. These medications must be monitored carefully to detect any side effects, which can include increased or worsened arrhythmias. Patients on such medications are advised to become familiar with taking their own pulse, so that any abnormal rhythm will be promptly discovered.

Older and sicker patients tend to benefit the most from ICD implantation. For individuals recovering from a heart attack, a temporary, nonimplanted type of defibrillator may be recommended in order to reduce the heightened risk of sudden cardiac death due to ventricular fibrillation and other arrhythmias.

The wearable cardioverter defibrillator (WCD), approved by the U.S. Food and Drug Administration in 2001, fits over the shoulders and chest and looks a bit like a gun holster. Sensors lead from the area of the heart to a small, battery-operated defibrillator worn on a belt. As with the ICD, the wearable version detects the arrhythmia and then shocks the heart into resuming a normal rhythm.