Which arrhythmias are shockable

When ACLS providers conduct a rhythm check, if that rhythm check reveals a shockable rhythm — VFib or pulseless V-tach — they will prepare to deliver a shock, while also ensuring the continuation of high-quality CPR while the unit is charging and in between shocks. Ventricular fibrillation or VFib is a common cause of out-of-hospital cardiac arrest.

In VFib cases, the heart quivers ineffectively and as a result, no blood is pumped out. VFib can either be fine or coarse. Coarse VFib is more likely to convert after defibrillation than fine VFib. Fine VFib can sometimes be mistaken for asystole. However, the treatments for asystole and VFib are different, therefore, ACLS providers must be able to differentiate between the two.

When in doubt, though, it is acceptable to deliver a shock. If in doubt, it is acceptable to deliver a shock. If it is fine v-fib, you may terminate the rhythm; however, if the rhythm is asystole, defibrillation will be ineffective and you can follow the asystole protocol with confidence.

Supraventricular tachycardia, or SVT, is far different than the rhythms discussed above, which originate in the ventricles. Patients in a supraventricular tachycardia will have a rapid rhythm with a heart rate greater than beats per minute and a stimulus that originates above the ventricles. Patients with an SVT may be relatively stable with few symptoms, or profoundly unstable with severe signs and symptoms related to the rapid heart rate.

Patients who are unstable, or who do not respond to medication will require electrical therapy. Arias E, Xu J. United States Life Tables, National Vital Statistics Reports, ; 68 7.

Cardiac Arrest Registry to Enhance Survival. Delgado H. Principles of External Defibrillators. IntechOpen, ; www. Mayo Clinic. Ventricular fibrillation, www. Ventricular tachycardia, www. Pulseless Electrical Activity. StatPearls [Internet], ; www. He has worked as a firefighter and paramedic in inner-city, rural, and military communities.

Currently he serves as a full-time civilian firefighter for the U. He is also an EMS instructor trainer for the U. Reach him at rconktraining gmail. Sign in. EMS World Expo. Current Issue. Issue Archives. Start Print Subscription. Renew Print Subscription. Start Digital Subscription. Patient Care. Expo on Demand. CE Articles. Online Product Guide.

Contact Us. Advisory Board. About Us. Copied to clipboard. Objectives Upon conclusion of this course, students will be able to: Describe basic cardiac physiology and the electrical, mechanical and hydraulic functions of the heart; Demonstrate comprehension of AED technology and protocols; Understand and differentiate between common shockable and nonshockable cardiac rhythms; Use rhythms to guide clinical decision making in Advanced Cardiac Life Support.

Basics of the Heart To understand all the AED is telling us, we must first understand how the heart works. Words of caution: The AED is only able to interpret the electrical activity of the heart. We still must ensure pulse checks are done, as one of the shockable rhythms is able to have a pulse with it. Shockable Rhythms The application of energy to the heart is not a jump-start, as it is often described.

Nonshockable Rhythms Nonshockable rhythms are ones in which the electrical system may be working properly or be completely inoperable, but in either instance electrical therapy would not be likely to restore a normal rhythm. Conclusion Understanding what the AED is telling us can help to guide our expectations of patient care and outcome in out-of-hospital cardiac arrest.

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Choices Significantly worse, frequent long waits. Moderately worse, occasional long waits. Minimally worse, infrequent long waits. Read next. March 01, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on. You've successfully added to your alerts.