The cause of ventricular fibrillation is not always known but it can occur during certain medical conditions. V-fib most commonly occurs during an accute heart attack or shortlt thereafter. When heart muscle does not get enough blood flow, it can become electrically unstable and cause dangerous heart rhythms. A heart that has been damaged by a heart attack or other heart muscle damage is vulnerable to V-fib. Other causes include electrolyte abnormalities such as low potassium, certain medicines, and certain genetic diseases that affect the hearts ion channels or electrical conduction.