How Can You Distinguish V-Fib From V-Tach?

How Can You Distinguish V-Fib From V-Tach?

​Both V-tach and V-fib are considered medical emergencies. Thus, the ability to distinguish between the two rhythms is necessary to ensure an appropriate intervention and treatment. For example, non-sustained V-tach may be addressed with medication in some cases, while V-fib and pulseless V-tach require immediate cardiopulmonary resuscitation (CPR) and defibrillation.

Ventricular Fibrilation

Ventricular fibrillation (V-fib) is most often characterized by a fast, abnormal heart rhythm caused by ventricle walls quivering or twitching instead of pumping blood. It can lead to sudden cardiac arrest and sudden cardiac death. Prior to experiencing V-fib, a patient may manifest shortness of breath, gasping for air, chest pain, lightheadedness, and nausea.

ECG Characeristics of V-Fib

​1. No clear QRS complexes, P waves, or T waves
2. Electrical activity is disorganized
3. The rate appears very rapid – up to 600 beats per minute
4. Coarse Vfib resembles a squiggly line, waves are 3 mm or larger
5. Fine Vfib features an almost straight line, waves are less than 3 mm

Ventricular Tachycardia

Ventricular tachycardia occurs when one of the heart’s ventricles takes over the pacemaker duty and causes the heartbeat to speed up. In addition to a sensation that the heart is beating too fast, a patient might experience a shortness of breath, light-headedness or fainting, and/or chest pain. However, some individuals do not experience any symptoms with V-tach, particularly if the episode is brief and/or lasting under 30 seconds which is known as non-sustained V-tach. Non-sustained V-tach with symptoms may be treated with medication to control the heart rate.

ECG Characteristics of V-Tach

​1. Wide QRS complexes greater than 0.14 seconds
2. QRS complexes are not preceded by the usual P waves
3. Occasional R intervals that are not typically regular.
4. Ventricular rate is usually between 150 and 250 beats per minute
5. No atrial rate can be determined.

Let's Look at the ECG differences

An organized pattern is present in a normal sinus rhythm. ​ P waves, QRS complexes, and T waves show up as 3 distinct waves, equally spaced and similar in size.

Wide, irregular QRS complexes occur with occasional P waves. The ability to detect a differences between the QRS complex and T-wave is often difficult.

There are no clearly visible P-waves, T-waves, or QRS complexes. The rate may be as fast as 600 beats per minute and the deflections will vary and often decrease.

When every second counts, your ability to quickly distinguish the difference between V-fib and V-tach can essentially mean the difference between life and death. Getting training and certification now can prepare you for cardiac arrest emergencies in the future. Make sure you are equipped with the knowledge and practice you need to give your patients the highest level of care.

With instructors at Help-A-Heart CPR that are committed to making classes interactive and engaging you will find it easy to learn and become empowered with lifesaving skills and new information. With classes offered 100% online, in-person and on-site, we have a training schedule that can accommodate even the busiest professional. Check out our class schedule today to find the course that suits your schedule and accommodates your training needs.