This document discusses cardiac rhythms addressed by Advanced Cardiac Life Support (ACLS). It describes ventricular fibrillation and ventricular tachycardia as life-threatening rhythms where the heart does not pump effectively. Pulseless ventricular tachycardia and ventricular fibrillation are treated the same in ACLS with defibrillation to restore an organized rhythm. Pulseless electrical activity and asystole are also described as unshockable rhythms where the heart does not pump blood effectively.

1. ADVANCED CARDIAC LIFE
SUPPORT (ACLS)

2. AHA Chains of Survival for adult IHCA and OHCA.

3. BLS Survey

4. ACLS Survey

5. • Pulseless ventricular tachycardia (VT) and Ventricular fibrillation (VF) are life-
threatening cardiac rhythms that result in ineffective ventricular contractions. The
ventricular motion of VF is not synchronized with atrial contractions.
• VT is a condition in which the ventricles contract more than 100 times per
minute.
• VF is a rapid quivering of the ventricular walls that prevents them from pumping.
• Pulseless VT, occurs when ventricular contraction is so rapid that there is no
time for the heart to refill, resulting in undetectable pulse.
• In both cases, individuals are not receiving adequate blood flow to the tissues.
• Despite being different pathological phenomena and having different ECG
rhythms, the ACLS management of pulseless VT and VF are essentially the
ADVANCED CARDIAC LIFE SUPPORT

6. • An AED reads and analyzes the rhythm and determines if a shock is needed.
• The AED is programmed to only prompt the user to defibrillate pulseless VT
and VF rhythms.
• The machine does not know if the individual has a pulse or not. This is the
primary reason you should not use an AED in someone with a palpable pulse.
• ACLS responses to pulseless VT and VF within a hospital will likely be
conducted using a cardiac monitor and a manual defibrillator.
ADVANCED CARDIAC LIFE SUPPORT

7. • Pulseless electrical activity (PEA) and asystole are related cardiac rhythms they
are both life-threatening and unshockable cardiac rhythms.
• Asystole is a flat-line ECG. There may be a subtle movement away from
baseline (drifting flat-line).
• PEA may include any pulseless waveform with the exception of VF, VT, or
asystole. May have organized or semi organized electrical activity.
• Hypovolemia and hypoxia are the two most common causes of PEA. They are
also the most easily reversible and should be at the top of any differential
diagnosis.
ADVANCED CARDIAC LIFE SUPPORT