Table 66135.

Intravenous Pharmacological Agents for Heart Rate Control in Patients With Atrial Fibrillation

Drug*Loading DoseOnsetMaintenance DoseMajor Side EffectsClass Recommendation
HF indicates heart failure.
*Drugs are listed alphabetically within each class of recommendation.
**Type I in congestive HF.
†Type IIb in congestive HF.
‡Only representative members of the type of beta-adrenergic antagonist drugs are included in the table, but other, similar agents could be used for this indication in appropriate doses.
Diltiazem0.25 mg/kg IV over 2 min2–7 min5–15 mg per hour infusionHypotension, heart block, HFI
Esmolol0.5 mg/kg over 1 min5 min0.05–0.2 mg·kg−1·min−1Hypotension, heart block, bradycardia, asthma, HFI
Metoprolol2.5–5 mg IV bolus over 2 min; up to 3 doses5 minNAHypotension, heart block, bradycardia, asthma, HFI
Propranolol0.15 mg/kg IV5 minNAHypotension, heart block, bradycardia, asthma, HFI
Verapamil0.075–0.15 mg/kg IV over 2 min3–5 minNAHypotension, heart block, HFI
Digoxin0.25 mg IV each 2 h, up to 1.5 mg2 h0.125–0.25 mg dailyDigitalis toxicity, heart block, bradycardiaIIb**