Tachycardia and its ACLS algorithm | ACLS-Algorithms.com


  1. Abbie says

    If a patient had a syncopal episode in the community and then was seen in the emergency department and found to be in SVT, would this be classed as stable or unstable?
    If the patient was conscious and had no evidence of cerebral hypoperfusion at the time of assessment, but had a history of a syncopal episode, how should this be managed?

    Many thanks,

    • ACLS says

      The question of whether the patient is stable or unstable would be determined at the time of the assessment and based upon the patient’s condition at the time of the assessment. In the emergency room if they had no evidence of cerebral hypo perfusion and no signs or symptoms of instability then they would be considered stable.

      Kind regards,

  2. Khine Khine says

    Hi, a case of a patient with DDD(R) pacemaker underlying tachy-brady arrhythmia who developed fast atrial fibrillation. ECG generated HR of 157bpm and a patient is hypotensive and BP machine cannot capture the actual reading. Patient remains conscious and asymptomatic (No signs of cerebral hypo perfusion and shock).
    Is it considered stable AF or unstable AF?
    What would be the treatment to intervene fast AF? IV anti-arrhythmic or DC synchronised cardioversion?

    • ACLS says

      That would be a borderline stable/unstable issue. If the patient is conscious and asymptomatic then the best thing would be to determine what that blood pressure is. Also, is there a palpable pulse? Sometimes a pulse pressure tells you a lot about perfusion.

      I think most physicians in this case would go with a IV anti-arrhythmic. Would begin anticoagulant therapy if not already going and perform a transesophageal echocardiogram in order to prepare for synchronized cardioversion.

      Kind regards,

  3. Rose says

    If you do one dose of adenosine, can you then deem them unstable and cardiovert? Or do you need to do both doses?

    • ACLS says

      And unstable condition would be identified based upon the patient’s vital signs and also the assessment. If the patient is unstable then different interventions other than adenosine should be used. Kind regards, Jeff

  4. Robbie D says

    If after the first initial shock during Cardio version at 50j you do not cardiovert, when time frame do you initiate the next 100j….150j…..200j?

  5. Shaz says

    Hi, if patient have normal blood pressure (130/89mmHg) and pulse rate of 180, but have cool and clammy peripheries, is it stable or unstable tachycardia?

    • ACLS says

      If these are the only symptoms that the patient is experiencing then this would be considered stable tachycardia.

      Kind regards,

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