Safety Training Seminars


Safety Training Seminars

American Heart Association Training Center official seal – Safety Training Seminars

Tachycardia ACLS Algorithm - 2025 Guidelines Coming Soon

Tachycardia ACLS Algorithm

Tachycardia ACLS Algorithm

If your heart is beating too fast, it’s called tachycardia. For healthcare providers, knowing how to respond is critical. The Tachycardia ACLS (Advanced Cardiovascular Life Support) Algorithm provides a clear, step-by-step guide for managing patients with a rapid heart rate. With the American Heart Association (AHA) set to release updated guidelines in 2025, it’s a great time to review this essential protocol.

This guide breaks down the current algorithm in simple terms, making it easier to understand whether you’re a medical professional or just want to learn more.

What is Tachycardia?

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

The ACLS algorithm helps providers quickly assess the situation, determine the cause, and provide the right treatment. The first step is always to assess the patient using the ABCs—Airway, Breathing, and Circulation—and provide oxygen if needed and monitor their vital signs.

Stable vs. Unstable Tachycardia

The most important question in the Tachycardia Algorithm is whether the patient is stable or unstable. This decision directs all subsequent treatment.

A patient is considered unstable if they show serious signs and symptoms related to the fast heart rate. These include:

  • Hypotension: Low blood pressure.
  • Altered mental status: Confusion, dizziness, or loss of consciousness.
  • Signs of shock: Pale, cool, or clammy skin.
  • Ischemic chest pain: Discomfort or pressure in the chest due to lack of blood flow to the heart.
  • Acute heart failure: The heart cannot pump enough blood to meet the body’s needs.

If a patient is unstable, the immediate treatment is synchronized cardioversion. This procedure delivers a timed electrical shock to the heart to restore a normal rhythm. It’s a priority because unstable tachycardia can quickly lead to life-threatening conditions.

If the patient is stable, the provider has more time to identify the specific type of tachycardia using an electrocardiogram (ECG) and begin other treatments.

Treatment for Stable Tachycardia

For stable patients, the next step is to analyze the QRS complex on the ECG. The QRS represents the electrical impulse spreading through the ventricles (the lower chambers) of the heart.
Narrow QRS Complex (SVT)

If the QRS is narrow, it’s likely a supraventricular tachycardia (SVT), meaning the abnormal rhythm originates above the ventricles.

  1. Vagal Maneuvers: The first treatment is often asking the patient to perform actions like bearing down or coughing. These maneuvers can stimulate the vagus nerve and slow the heart rate.
  2. Adenosine: If vagal maneuvers don’t work, the drug adenosine is administered. It works quickly to block the abnormal electrical pathway in the heart.
  3. Other Medications: If adenosine is not effective, beta-blockers or calcium channel blockers may be used.
Wide QRS Complex

If the QRS is wide, it is considered ventricular tachycardia (VT) until proven otherwise. This is a more serious rhythm. Treatment involves antiarrhythmic medications like procainamide, amiodarone, or sotalol. In all cases, it’s crucial to seek expert consultation to determine the underlying cause and best long-term management.

Stay Current with Your ACLS Certification

The Tachycardia ACLS Algorithm is a vital tool for saving lives. As medical science evolves, so do the guidelines. The upcoming 2025 AHA updates will likely refine these protocols to improve patient outcomes even further.

Staying certified in ACLS ensures you are prepared with the latest life-saving techniques. At Safety Training Seminars, we offer American Heart Association-certified ACLS courses that make it easy to get and stay certified. Our blended program includes online coursework you can complete at your convenience, followed by a short, in-person skills session at one of our 70+ locations across California. You’ll receive your certification card the very same day. Contact us to learn more and book your class today.