2012 Volume 32 Issue 4 Pages 615-619
The lethal arrhythmia includes ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT), “unstable tachycardia” and “unstable bradycardia” based on a 2010 AHA guideline. Generally, “Unstable” refers to a condition in which vital organ function is acutely impaired or cardiac arrest is ongoing or imminent. When an arrhythmia causes a patient to be unstable, immediate intervention is indicated. Survival from VF/pulseless VT rhythms requires both basic life support (BLS) and advanced cardiovascular life support (ACLS) with integrated post-cardiac arrest care. In particular, early CPR and rapid defibrillation are essential. On the other hand, it is reasonable for us to initiate transcutaneous pacing (TCP) in unstable bradycardic patients who do not respond to atropine. Also, unstable tachycardia needs immediate synchronized cardioversion.
