Tachycardia ACLS Algorithm - 2025 Guidelines Coming Soon

Tachycardia ACLS Algorithm

When your heart is beating too fast, it is called tachycardia. For healthcare providers, knowing how to respond is key. The Tachycardia ACLS (Advanced Cardiovascular Life Support) Algorithm is a step-by-step guide with clear instructions for managing patients with a rapid heart rate. This is a really useful protocol for reviewing the American Heart Association (AHA) which will be issuing revised guidelines in 2025.

This guide breaks down the existing algorithm to help you grasp more clearly whether you’re a doctor or just interested.

What is Tachycardia?

Tachycardia refers to a heart rate over 100 beats per minute (bpm). Although it’s normal for your heart rate to rise during exercise or stress, persistent tachycardia at rest can be dangerous. It can stop the heart’s chambers from filling, decreasing blood flow to the rest of your body.

The ACLS algorithm assists physicians to perform rapid assessment, diagnose cause, and offer correct treatment. Using the ABCs — Airway, Breathing, and Circulation — the first thing is always to evaluate the patient, administer oxygen as required, and test for vital signs.

Stable vs. Unstable Tachycardia

The most critical thing in the Tachycardia Algorithm is whether the patient is stable or unstable. Ultimately, this decision is the basis for all other treatment.

A patient is unstable if they have significant signs/symptoms concerning the fast heart rate. Serious symptoms would indicate the patient lacks control over these events. These include:

Hypotension: Low blood pressure.
Altered mental status: Unexplained daze or loss of consciousness.
Signs of shock: Pale, cool, or clammy skin.
Ischemic chest pain: Pain in the chest that is discomfort or pressure caused by insufficient blood supply to the heart.
Acute heart failure: A heart failing to pump enough blood to feed the body.

If a patient is unstable, the next resort is synchronized cardioversion. This technique delivers a timed electrical shock to the heart to restore a normal rhythm. It is a priority because unstable tachycardia can quickly progress to life-threatening conditions.

When stable, the provider has extra time to assess the type of tachycardia with an electrocardiogram (ECG) and initiate further interventions.

Treatment for Stable Tachycardia

For patients who are stable, the next step is to analyze the QRS complex on the ECG. The QRS is the electrical impulse propagating through the ventricles (the lower chambers of the heart).

Narrow QRS Complex (SVT)

If the QRS is narrow, it’s probably supraventricular tachycardia (SVT), which is an abnormal rhythm above the ventricles.

Vagal Maneuvers: When starting treatment, many people ask the patient to do things like bear down or cough. These maneuvers can stimulate the vagus nerve and slow the heart rate.
Adenosine: If vagal maneuvers fail, the medication adenosine is given. It acts fast to block the abnormal electrical pathway in the heart.
Other medications: Beta blockers or calcium channel blockers, if adenosine does not work.

Wide QRS Complex

If the QRS is wide it is considered ventricular tachycardia (VT) until shown otherwise. This rhythm is a more serious one. Treatment may also include antiarrhythmic drugs such as procainamide, amiodarone, or sotalol. In all cases, it is crucial to seek expert consultation to establish the underlying cause and best long-term management.

Stay Current with Your ACLS Certification

Tachycardia ACLS Algorithm is an important means to save lives. As medical science advances, so too do the guidelines. The upcoming 2025 AHA updates will likely refine these protocols to improve patient outcomes even further.

By being certified in ACLS, you are armed with the latest life-saving techniques. We offer ACLS courses certified by the American Heart Association at Safety Training Seminars which are accessible to receive as well as maintain certification. Our blended version adds online coursework at your earliest convenience, and a brief in-person skills course at one of our 70+ locations in California. You will receive your certification card the very same day. Contact us to learn more and book your class today.