From Big Medical Encyclopedia

FIBRILLATION of VENTRICLES of HEART (Latin fibrilla a fibril) — pathological (chaotic, separate and occurring at different times) the reduction of separate muscle fibers of ventricles of heart not capable to support their effective work. Radical difference F. page from fibrillation of auricles (see. The ciliary arrhythmia) is preservation at the last blood circulations in an organism thanks to the continuing coordinate activity of ventricles of heart.

The factors promoting emergence F. pages, are a hypoxia, ischemia of a myocardium, intoxication, disturbances of electrolytic balance, electric and mechanical irritation of heart, low body temperature (lower than 28 °), a nerve -

II about - ps them iches to about e a cart at d en not, N r and-me singing of simiatomimetichesky pharmaceuticals during nek-ry types of an inhalation anesthesia and some other.

The most widespread, but theory of emergence, not standard in a crust, time, F. the page, is the theory of circulation of an excitation wave on the basis of the mechanism of a repeated entrance (re-entry) as a result of emergence of multiple local disturbances of conductivity in a myocardium and the carrying-out system of heart (see. Bouveret's disease, pathological physiology). At the same time the rhythm of reductions of the struck muscle fibers differs from a rhythm of reductions of other fibers and conditions for emergence F are created.

village of Klin, picture F. the page is characterized by a loss of consciousness, lack of pulse on peripheral and central arteries, the maximum expansion of pupils, emergence of breath of agonal type, and then and its termination: (see Terminaln ye states). T. page

of Fig. Electrocardiograms at fibrillation of ventricles of heart: in initial stages (j, 2) rhythmical isomorphic oscillations (a figure of «spindles») with a frequency of 10 — 12 of 1 sec. prevail high on a voltage (0,5 — 1,5 mV); in late stages (3 — 6) rhythmical gradually disappear and polymorphic oscillations which amplitude gradually decreases prevail.

with rare exception is a state spontaneously irreversible and inevitably leads to death of an organism if measures to its immediate elimination are not taken. If F. the page arises not during a thoracotomy when it is possible to watch a condition of heart visually, the authentic diagnosis F. page it is possible only at an electrocardiography; The ECG in these cases is characterized by the staging reflecting degree of a hypoxia and metabolic changes in a myocardium. In the characteristic of each stage (fig.) the look and ratio of fibrillar oscillations — rhythmical isomorphic and arrhythmic polymorphic matters. Absolutely clear boundary between stages does not exist.

From the practical point of view division of fibrillation into initial stages when the hypoxia of a myocardium moderate and is kept its potential ability to coordinate reductions after carrying out a defibrillation (see), and into late stages when the hypoxia of a myocardium is sharply expressed and carrying out a defibrillation is important does not eliminate F any more. page.

Most efficiently terminations F. the page is impact on heart a single bipolar electric impulse, duration to-rogo is close to an effective time of irritation of heart.

Bibliography: Goldberg of ER E. and

In and t of M. Treatment of patients with a serious illness of heart, the lane with English, M., 1979; At r in and the p N. L. Fibrillation and cardiac defibrillation, M., 1957; N of e-@ about a century and y V. A. Urgent problems of resuscitation, M., 1971; R and y with-to and on M. E. The pathophysiological analysis of origins of fibrillation of ventricles at acute coronary insufficiency, in book: Sudden death at acute coronary insufficiency, under the editorship of. I. K. Shkhvatsabaya and M. E. Ry-skinoy, page 73, M., 1968; The Guide to cardiology, under the editorship of E. I. Chazov, t. 3, M., 1982; Tobacco B. I., etc. Dynamics of spectral characteristics of an ECG at development of fibrillation of ventricles of heart, Anesteziol. and reanpmatol., No. 1, page 71, 1980; Atkins J. M and. lake of Ventricular conduction blocks and sudden death in acute myocardial infarction, New Engl. J. Med., v. 288, p. 281, 1973; In e with k C. S., Pritchard W. H. a. Feil H. S. Ventricular fibrillation of long duration abolished by electric shock, J. Amer. med. Ass., v. 135, p. 985, 1947; Chung E. K. Principles of cardiac arrhythmias, Baltimore, 1971; Gran efi eld P. F., Wit A. L. a. Hoffman B. F. Genesis of cardiac arrhythmias, Circulation, v. 47, p. 190, 1973; To

o u w e n h o-w e n W. Century and. To a y J. H. A simple electrical apparatus for the clinical treatment of ventricular fibrillation, Surgery, v. 30, p. 781, 1951; Peleska B.

Electric impulse in cardiac tachyarrhythmias, IEEE Trans, bio-med. engineering, v. 16, p. 123, 1969; Wiggers C. J. Studies of ventricular fibrillation caused by electric shock, Amer. Heart J., v. 5, p! 351, 1930. Century of H. Semenov.