88
Management
Table 22. Drugs for Pharmacological Conversion of Atrial
Fibrillation to Sinus Rhythm
Drug
Route of
Administration Loading Dose
Maintenance
Dose
Amiodarone IV 5–7 mg/kg or 300 mg* 1200–3000
mg via
continuous
infusion over
24 h
Flecainide
Oral
†
N/A 200 mg if <70
kg, 300 mg if
>70 kg, single
dose
Ibutilide IV ≥60 kg : 1 mg over 10 min
<60 kg : 0.01 mg/kg over 10 min
If arrhythmia does not terminate
within 10 min aer the end of the
first infusion, may administer a
second dose, equal to the first dose
N/A
Procainamide IV 1 g over 30 min 2 mg/min
continuous
infusion over
1 hour
Propafenone Oral N/A 450 mg if <70
kg, 600 mg if
>70 kg, single
dose
* Some studies have administered intravenous amiodarone for 24 hours followed by oral
administration.
