Would you consider amiodarone for the treatment of atrial fibrillation with RVR in patients who cannot tolerate beta blockers but have a high CHA2DS2-VASc score and are not on anticoagulation?

We typically do not due to risk of chemical cardioversion and precipitating an embolism.

I have found amiodarone to be of little efficacious use in the acute setting for any particular dysthymia. Calcium channel blockers continue to be the most effective and best tolerated medications for AFib with RVR for rate control pending further investigation into the status of potential clot form...

"Blind" cardioversion in this scenario is risky due to thromboembolic potential. Furthermore, amiodarone is a "dirty drug" with a very long half-life and can affect multiple organs concurrently (lungs, eyes, thyroid, etc). Thus, the decision to use should be carefully weighed and discussed with the ...

You can add nondihydropyridine CCBs if LVEF >40% and compensated, or digoxin. Triple therapy is rarely advised but an option to avoid rhythm strategy if stroke is a concern.

IV amiodarone takes 1hr to take effect, IV digoxin takes 5-30min to take effect.

Both IV metoprolol and diltiazem take effectiv...

INDICATIONS AND USAGE Because of its life-threatening side effects and the substantial management difficulties associated with its use (see “WARNINGS” below), Cordarone is indicated only for the treatment of the following documented, life-threatening recurrent ventricular arrhythmias when these have...