Ventricular Fibrillation Differential Diagnoses

Updated: Jun 06, 2018
  • Author: Sandeep K Goyal, MD, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Diagnostic Considerations

In all adult cases, ischemic cardiomyopathy is at the top of the differential diagnosis of causes of ventricular fibrillation (VF). However, dilated cardiomyopathy (DCM) has become increasingly common. That is, the differential diagnosis typically relates to the underlying etiology rather than the rhythm per se. Occasionally, electrical artifact due to resuscitative efforts or repetitive muscular activity can superficially appear similarly to very coarse VF. However, it is often possible to see the underlying narrower electrocardiographic (ECG) complexes in the putative VF rhythm strip. Accordingly, whenever possible, the ECGs from the reported VF episode should be directly reviewed.

In children and adolescents, hypertrophic cardiomyopathy (HCM) is most common. VF in these patients often occurs at rest or with mild exertional activity, but vigorous exercise is the trigger in a significant portion of cases.

Differential Diagnoses