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.
