In ACLS, which antiarrhythmic is recommended for VT/VF if defibrillation is not converting the rhythm?

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Multiple Choice

In ACLS, which antiarrhythmic is recommended for VT/VF if defibrillation is not converting the rhythm?

When a shockable rhythm like VT or VF persists after defibrillation attempts, the next step is to give an antiarrhythmic to help restore a perfusing rhythm. Amiodarone is the recommended choice in ACLS for refractory VT/VF because it has broad antiarrhythmic effects that stabilize cardiac membranes and suppress recurrent ventricular ectopy, improving the chance of rhythm conversion and survival in ischemic hearts. The typical approach is an IV bolus of 300 mg, with a possible additional 150 mg if needed. Magnesium is reserved for cases of torsades de pointes or when a prolonged QT is implicated, not for standard VT/VF. Adenosine is used for certain supraventricular tachycardias, not for VT/VF. Lidocaine can be used if amiodarone is unavailable or contraindicated, but it is considered a second-line option because amiodarone generally provides better efficacy with a more favorable profile in the setting of cardiac arrest.

When a shockable rhythm like VT or VF persists after defibrillation attempts, the next step is to give an antiarrhythmic to help restore a perfusing rhythm. Amiodarone is the recommended choice in ACLS for refractory VT/VF because it has broad antiarrhythmic effects that stabilize cardiac membranes and suppress recurrent ventricular ectopy, improving the chance of rhythm conversion and survival in ischemic hearts. The typical approach is an IV bolus of 300 mg, with a possible additional 150 mg if needed.

Magnesium is reserved for cases of torsades de pointes or when a prolonged QT is implicated, not for standard VT/VF. Adenosine is used for certain supraventricular tachycardias, not for VT/VF. Lidocaine can be used if amiodarone is unavailable or contraindicated, but it is considered a second-line option because amiodarone generally provides better efficacy with a more favorable profile in the setting of cardiac arrest.

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