1. ACLS Rhythms Cheat Sheet
Amanda Hooper

2. Normal Sinus Rhythm

3. Asystole PEA Vfib/pulseless Vtach
Arrest Rhythms
Asystole
PEA
Vfib/pulseless Vtach

4. Agonal Rhythm/Asystole

5. Pulseless Electrical Activity (PEA)
Note that PEA can look like any rhythm (any organized electrical activity), but if no pulse it is PEA

6. Course Ventricular Fibrillation

7. Fine Ventricular Fibrillation

8. Non-Arrest Rhythms

9. One very important thing that seems like it should be easy but I always have to remember how to do: determine the rate…
Find a QRS complex that is closest to a dark vertical line. Then count the number of “big boxes” until the next QRS complex. For each “big box” you pass, select the next number off the mnemonic " " to estimate the rate.
Alternatively, you can count the number of big boxes between two QRS complexes and divide 300 by that number.

10. Note the rate is > 100 bpm
Sinus Tachycardia
Note the rate is > 100 bpm

11. Note it is “irregularly irregular” and there are no definite p waves
Atrial Fibrillation
Note it is “irregularly irregular” and there are no definite p waves

12. Note the “saw-tooth” pattern
Atrial flutter
Note the “saw-tooth” pattern

13. Reentry Supraventricular Tachycardia
This is a regular, narrow complex tachycardia without P waves, usually with a sudden onset and cessation

14. Monomorphic Ventricular Tachycardia
With ventricular rhythms, QRS is usually wide. V tach is more organized electrical activity than v fib, but v tach often deteriorates into v fib so both are very bad!

15. Polymorphic Ventricular Tachycardia

16. Torsades de Pointes A special type of polymorphic Vtach-
Note the “spindling” in the QRS complexes

17. Sinus Bradycardia
Note the rate <60 bpm. Could be physiologic or symptomatic depending on the patient.

18. Note the increased PR interval
1st Degree AV Block
Note the increased PR interval

19. 2nd Degree AV Block: Mobitz type I (Wenckebach)
Note the progressive lengthening of the PR interval until one P wave (arrow) is not followed by a QRS

20. 2nd Degree Block: Mobitz type II
Note the regular PR interval until beats are dropped.

21. 3rd Degree AV Block
Note the regular P waves and regular ventricular “escape beats” but no relationship between the P waves and escape beats.