Advanced Cardiovascular Life Support (ACLS) is a training program developed by the American Heart Association (AHA) that teaches healthcare providers the skills to respond to and manage life-threatening cardiovascular emergencies, including cardiac arrest, stroke, acute myocardial infarction, and respiratory failure. ACLS builds on Basic Life Support (BLS) skills and adds advanced interventions including cardiac rhythm recognition and interpretation, defibrillation, airway management, intravenous and intraosseous access, and pharmacological interventions for cardiac arrest and peri-arrest situations.
ACLS certification is required or expected for a wide range of healthcare providers: physicians (MDs and DOs), physician assistants, nurse practitioners, registered nurses working in emergency departments, intensive care units, surgical suites, cardiac care units, and recovery rooms, paramedics and advanced EMTs, respiratory therapists, and other providers who may be first responders to in-hospital emergencies. Hospital policies specify which staff must hold current ACLS certification as a condition of employment. Many hospital credentialing and privileging processes require current ACLS for physicians and advanced practice providers before allowing them to perform certain procedures or work in specific clinical environments.
ACLS certification is issued by the American Heart Association and is valid for 2 years. After 2 years, certification must be renewed through an AHA ACLS Renewal course. The content of ACLS is updated with each revision of the AHA CPR and ECC (Emergency Cardiovascular Care) guidelines, which are published approximately every 5 years based on the most current resuscitation science.
ACLS is offered exclusively through AHA-authorized training centers. Only courses from AHA Training Centers produce official AHA ACLS certification cards — which is what healthcare employers require. Finding an authorized training center is the first step.
The primary resource for finding ACLS courses is the AHA's training center finder at cpr.heart.org. Click 'Find a Course' and filter by course type (ACLS), your zip code, and preferred date range. Results show AHA-authorized training centers near you with contact information and available course dates. Training centers include hospitals, healthcare training organizations, community colleges, and dedicated clinical education companies.
Many hospitals operate their own AHA-authorized training centers and offer ACLS courses primarily for their staff, but may open excess spots to non-employees. Contact the Education or Staff Development department at hospitals in your area to ask about ACLS course availability and whether non-employees can enroll. Hospital-based courses are often less expensive than private training companies and are geographically convenient for providers who work nearby.
AHA offers HeartCode ACLS, a blended learning program that combines an online self-paced module with an in-person skills check session. The online module can be completed at any time and takes approximately 4 to 6 hours. After completing the online module, you schedule a skills check at an AHA training center — typically 2 to 3 hours for the hands-on portion, megacode simulation, and AHA certification card issuance. HeartCode ACLS allows you to learn the cognitive content on your own schedule and come to the in-person session already knowing the material, shortening the in-person time commitment.
AHA offers ACLS in several formats designed to accommodate different learners and schedules. Understanding the differences helps you choose the right course for your needs.
The traditional AHA ACLS Initial course is a full-day (6 to 8 hours) in-person class taught by an AHA-certified instructor. The course covers cardiac rhythm recognition, ACLS algorithms, pharmacology, airway management, team dynamics, and case simulations with hands-on skills practice. The megacode — a comprehensive simulation scenario where you lead or participate in a cardiac arrest resuscitation — is the culminating skills evaluation. In-person courses are ideal for providers who learn best in structured group settings with immediate instructor feedback.
HeartCode ACLS consists of an online self-paced learning module followed by a hands-on skills session at an AHA training center. The online portion covers all the cognitive content: rhythm recognition, ACLS algorithms, pharmacology principles, and case presentations. The in-person skills session (approximately 2 to 3 hours) focuses on hands-on practice and evaluation — the megacode simulation, airway skills, and debriefation. HeartCode ACLS is the most flexible option for providers with unpredictable schedules or those who prefer self-paced online learning over traditional classroom instruction.
Providers renewing an existing ACLS certification take an abbreviated renewal course rather than the full initial course. AHA ACLS Renewal is typically 4 to 6 hours in-person or 2 to 3 hours in-person following the HeartCode online module. Renewal courses assume you already have the foundational knowledge and focus on updates to algorithms and guidelines since your last certification, skills practice, and megacode evaluation. Many training centers offer same-day ACLS renewal to accommodate providers with busy clinical schedules.
ACLS training addresses the systematic approach to life-threatening cardiovascular and respiratory emergencies. The curriculum is organized around the AHA algorithms for specific cardiac rhythms and clinical presentations.
ACLS providers must recognize and appropriately respond to the rhythms that cause or complicate cardiac arrest and peri-arrest states. Rhythms covered include: ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) — the shockable rhythms treated with defibrillation; pulseless electrical activity (PEA) and asystole — non-shockable arrest rhythms requiring high-quality CPR and treatment of reversible causes (the Hs and Ts); symptomatic bradycardia — treated with atropine, pacing, or dopamine/epinephrine; and stable and unstable supraventricular tachycardia (SVT), atrial fibrillation, and Wolff-Parkinson-White — managed based on hemodynamic stability. The AHA systematic approach — assessment of airway, breathing, and circulation — governs every patient encounter.
ACLS pharmacology covers the drugs used in cardiac arrest and peri-arrest situations. Key drugs: epinephrine (1 mg IV/IO every 3 to 5 minutes during cardiac arrest — the primary vasopressor in arrest), amiodarone and lidocaine (antiarrhythmics for VF/pulseless VT refractory to initial defibrillation), adenosine (for SVT — given as rapid IV push with saline flush), atropine (for symptomatic bradycardia), and dopamine/norepinephrine (for post-arrest hemodynamic support). Knowing doses, routes, and timing of ACLS drugs is essential for the megacode simulation and for clinical practice.
ACLS covers the management of patients who achieve return of spontaneous circulation (ROSC) after cardiac arrest — a phase called post-cardiac arrest care or post-resuscitation care. Key elements: targeted temperature management (TTM) for comatose survivors, hemodynamic optimization (MAP target ≥65 mmHg), ventilation management (avoiding hyperoxia and hypoxia), coronary angiography for STEMI patients, and neurological prognostication. Post-arrest care is among the most important aspects of improving survival to hospital discharge after cardiac arrest.
ACLS certification expires every 2 years. Renewing before expiration is important — many employers will not allow clinical work with an expired certification, and some hospitals require renewal at least 30 days before expiration to avoid credential lapses in their systems.
ACLS renewal requires completing an AHA ACLS Renewal course from an authorized training center. You cannot renew an expired ACLS certification — if your certification has already expired, you must complete the full initial ACLS course, not the abbreviated renewal. Find a renewal course through the AHA Training Center Finder at cpr.heart.org. Many employers allow ACLS renewal during work hours or provide employer-sponsored renewal courses through the hospital's training center.
The AHA updates its CPR and ECC guidelines approximately every 5 years. If major guideline updates occur between your renewal cycles, the content of ACLS courses will change. The most recent major update was in 2020 (AHA Guidelines for CPR and ECC 2020). Staying current with AHA guideline publications — available through Circulation, the AHA's flagship journal — helps you apply updated evidence before your formal renewal cycle.
Keep a record of your ACLS expiration date. Many providers use the AHA's digital credential system (via CPR Verification or the training center registry) to access digital copies of their certification cards. Hospital credentialing offices also track provider certification expiration dates and typically notify providers when renewal is approaching. Do not rely solely on your employer's notification — take personal responsibility for tracking and renewing your own certifications.