Table 11. Recommended Drug Doses for Pharmacological
Cardioversion of AF
Drug
Route of
Administration Dosage
Potential Adverse
Effects
Amiodarone
a
Oral 600-800 mg QD in
divided doses to a total load
of ≤10 g, then 200 mg QD as
maintenance
Phlebitis (IV),
hypotension,
bradycardia, QT
prolongation,
torsades de pointes
(rare), GI upset,
constipation,
increased INR
IV 150 mg over 10 min, then
1 mg/min for 6 h, then
0.5 mg/min for 18 h or change
to oral dosing
Dofetilide Oral CrCl
(mL/min)
Dose
(mcg BID)
QT prolongation,
torsades de pointes;
adjust dose for renal
function, body size,
and age
>60
40-60
20-40
<20
500
250
125
Not
recommended
Flecainide Oral 200-300 mg × 1
b
Hypotension, atrial
flutter with 1:1
AV conduction,
ventricular
proarrhythmia; avoid
in patients with
CAD and significant
structural
heart disease
Ibutilide IV 1 mg over 10 min; may repeat
1 mg once if necessary (weight
<60 kg use 0.01 mg/kg )
QT prolongation,
torsades de pointes,
hypotension
Propafenone Oral 450-600 mg × 1
b
Hypotension, atrial
flutter with 1:1
AV conduction,
ventricular
proarrhythmia; avoid
in patients with
CAD and significant
structural
heart disease
a
Multiple dosing schemes exist for the use of amiodarone.
b
Recommended given in conjunction with a beta blocker or nondihydropyridine calcium channel
antagonist administered ≥30 minutes before administering the Vaughan Williams Class IC agent.
Treatment
18
