74
Management
Table 21. Pharmacological Agents for Rate Control in
Patients With Atrial Fibrillation
Intravenous
Administration
Oral
Maintenance
Dose
Elimination
Half-Life Notes
Verapamil 5–10 mg over ≥2
min (may repeat
twice); then 5 mg/h
continuous infusion
(max 20 mg/h)
180–480 mg
daily (ER)
IV: 6–8 h
Oral: 2–7 h
ER: 12–17 h
Avoid in
HFrEF
Digitalis glycoside
Digoxin 0.25–0.5 mg over
several min; repeat
doses of 0.25 mg
every 6 h (maximum
1.5 mg/24 h)
0.0625–0.25
mg daily
1–2 d Renally
eliminated
Increased
mortality
at plasma
concentrations
exceeding 1.2
ng/mL
Other
Amiodarone 150–300 mg IV
over 1 h, then
10–50 mg/h over
24 h
100–200 mg
daily
(generally IV
form used for
rate control)
IV: 9–36 d
Oral:
26–107 d
Loading
dose 6–10 g
administered
over 2–4 wk;
can combine IV
and oral dosing
to complete
(cont'd)
