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Cardioversion upto7 Days

Drug	Class of Recommendation/Level of Evidence	Dosage
Dofetilide	I A	Creatinine clearance(ml/min) Dose (mg) >60 500 40 to 60 250 20 to 40 125 <20 Contraindicated
Flecainide	I A	Oral: 200 to 300 mg Intravenous: 1.5 to 3.0 mg/kg over 10 to 20 min
Ibutilide	I A	1 mg over 10 min; repeat 1 mg when necessary
Propafenone	I A	Oral: 600 mg Intravenous: 1.5 to 2.0 mg/kg over 10 to 20 min
Amiodarone	IIa A	Oral: Inpatient: 1.2 to 1.8 g per day in divided dose until 10 g total then 200 to 400 mg per day maintenance or 30 mg/kg as single dose Outpatient: 600 to 800 mg per day divided dose until 10 g total then 200 to 400 mg per day maintenance. Intravenous: 5 to 7 mg/kg over 30 to 60 min then 1.2 to 1.8 g per day continuous IV or in divided oral doses until 10 g total then 200 to 400 mg per day maintenance.

Cardioversion after 7 Days

Drug	Route	Dosage
Dofetilide	Oral	Creatinine clearance(ml/min) Dose (mg) >60 500 40 to 60 250 20 to 40 125 <20 Contraindicated
Amiodarone	Oral or Intravenous	Oral: Inpatient: 1.2 to 1.8 g per day in divided dose until 10 g total then 200 to 400 mg per day maintenance or 30 mg/kg as single dose Outpatient: 600 to 800 mg per day divided dose until 10 g total then 200 to 400 mg per day maintenance. Intravenous: 5 to 7 mg/kg over 30 to 60 min then 1.2 to 1.8 g per day continuous IV or in divided oral doses until 10 g total then 200 to 400 mg per day maintenance.
Ibutilide	Intravenous	1 mg over 10 min; repeat 1 mg when necessary

Drugs which enhance the efficacy of cardioversion when given prior to the procedure: (Level of recommendation: IIa B)

• Amiodarone
• Flecainide
• Ibutilide
• Propafenone
• Sotalol

Drug Dosages for Maintenance of Sinus Rhythm

Following table summarizes the list of most commonly used drugs and their dosages for maintenance of sinus rhythm:

Drug	Dose
Amiodarone	100 to 400 mg
Disopyramide	400 to 750 mg
Dofetilide	5000 to 1000 mcg
Flecainide	200 to 300 mg
Procainamide	1000 to 4000 mg
Propafenone	450 to 900 mg
Quinidine	600 to 1500 mg
Sotalol	160 to 320 mg