Your ACLS Guide to Atrial Fibrillation – Know Its Cause and Understand Its Treatment

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ACLS Treatment for Atrial Fibrillation

What is Atrial Fibrillation (A-Fib) in ACLS?

A-fib is a type of irregular heart rhythm (tachycardia) where atrial activity is erratic or chaotic; the AV node can be bombarded with more than 500 pulses per minute, since there’s multiple reentrant circuits occurring in unpredictable patterns. A-fib is more common than atrial flutter.

Atrial Fibrillation as visualized on an ECG monitor
Atrial Fibrillation as visualized on an ECG monitor

RELATED: Shockable Rhythms in ACLS

What are the Symptoms of Atrial Fibrillation in ACLS?

Patients can be asymptomatic. They may also have symptoms that include:

  • palpitations,
  • shortness of breath,
  • dizziness and/or fatigue (similar to those seen in atrial flutter).

Unstable tachycardias like atrial fibrillation require immediate ACLS (Advanced Cardiac Life Support) attention.

RELATED: Atrial Fibrillation and ACLS Protocols

What is the Treatment for Atrial Fibrillation in ACLS?

To treat A-fib, you must first determine if the tachycardia is producing severe symptoms and/or hemodynamic instability. Follow with a treatment of supplemental oxygen and monitoring of the heart, and establish an IV. If there is any hemodynamic instability, induce synchronized cardioversion.

You must then determine any underlying causes such as noncardiac pain or an illness that could mimic symptoms of acute cardiac distress. For example, a heart rate between 100–130 will often represent sinus tachycardia that is caused by an underlying systemic condition or injury, which would require certain specific treatments for that condition or injury. Tachycardia with a heart rate over 150 BPM, however, is a warning sign that may signal an emergent situation requiring ACLS intervention.

Atrial fibrillation will be treated as an irregular narrow-complex tachycardia. The ACLS provider will:

  • Obtain a 12-lead ECG, and seek expert consultation.
  • Attempt rate control with beta-blockers or calcium channel blockers.
  • Follow the treatment pathway for irregular narrow-complex tachycardia (see below).
Correct dopamine dose in ACLS
Vials of medications and a syringe.

How Do You Know Which Treatment Pathway for Atrial Fibrillation is Correct?

ACLS providers use algorithms to guide them through the diagnostics and treatment of various cardiac events, including tachycardias. To determine the correct pathway for A-fib, an ACLS provider will follow the latest version of the Adult Tachycardia with a Pulse Algorithm as recommended by the American Heart Association (AHA).

RELATED: ACLS Algorithm for Supraventricular Tachycardia (SVT)

Following this algorithm means that you will be treating the A-Fib patient with the most up-to-date evidence-based ACLS research that is endorsed by the AHA–considered the gold standard in cardiac research. Be sure to get familiar with all of the most recent versions of the ACLS algorithms to stay ahead of the curve.

Where Can I Learn More About Treatment for Atrial Fibrillation in ACLS?

The Medical ProCerts Advanced Cardiovascular Life Support certification teaches medical providers how to use and interpret the algorithms used in ACLS–including atrial fibrillation. This comprehensive online ACLS course was specifically developed to create an affordable, informative, user-friendly experience to help you simply certify without the time and expense of training in-class.

RELATED: ACLS Algorithms

Our courses are designed in accordance with the most recent guidelines detailed by the American Heart Association.

Medical ProCerts ACLS Certifications are:

  • Good for first-time ACLS certification
  • Also designed for ACLS recertification
  • Completed at Your Own Pace 100% Online
  • Valid for 2 Years
  • AHA & ILCOR Compliant
  • Employer Approved

Learn more and sign up today at

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