Agents Used in the Treatment of Arrhythmias and Advanced Cardiovascular Life Support

Advanced Cardiovascular Life Support (ACLS) guidelines recommend certain drugs for hemodynamic stabilization, prevention of collapse, stabilization of a perfusing rhythm, improving peripheral resistance and cardiac output, and restoration of organ perfusion. It is known that no antiarrhythmic agent increases the percentage of patients discharged with good neurological status. For this reason, the commencement of medications and establishing vascular access should not delay high-quality CPR.

ACLS guidelines recommend drug adrenaline in the asystole algorithm and in those with cardiac arrest due to ventricular fibrillation (VF). For pulseless electrical activity (PEA)-related cardiac arrest, adrenaline and, in some cases, sodium bicarbonate is recommended. The drugs used in VF and pulseless VT (PVT) apart from adrenaline are vasopressin, amiodarone, lidocaine, esmolol, magnesium, and procainamide in selected situations. This chapter provides a brief outline of arrhythmias commonly encountered in routine clinical practice, together with principles of ACLS and indications and usage of resuscitative agents employed in these situations.

Keywords: Adrenaline, Advanced Cardiovascular Life Support, Amiodarone, Antiarrhythmics, CPR, Lidocaine, Sodium bicarbonate, Ventricular fibrillation.