Table 1.

Drugs used for cardioversion of AF. Vernakalant is not approved in the USA and ranolazine is not approved anywhere for this indication. Ibutilide is only sporadically approved outside the USA.

Drug	Dose	Efficacy	Acute Side Effects
Flecainide	200-300 mg p.o. stat 2mg/kg i.v. over 10 min	55-85%	Hypotension, rapid AFL, QRS widening
Propafenone	450-600 mg p.o. stat 2 mg/kg i.v. over 10 min	52-85%	Hypotension, rapid AFL, QRS widening
Amiodarone	150 mg i.v. bolus, or 5 mg/kg i.v. over 1 hour	35-90% (delayed by 8-24 h)	Hypotension, bradycardia, QT prolongation (low risk of TdP), phlebitis
Ibutilide	1 mg i.v. over 10 min, repeat if necessary	25-50%	QT prolongation, TdP, bradycardia
Vernakalant	3 mg/kg i.v. over 10 minutes, then, if needed, after 15 minutes 2mg/kg over 10 minutes	48-62%	Hypotension (esp. in heart failure), QT prolongation (low risk of TdP)
Ranolazine	2 g p.o. stat	~60-70%	Well-tolerated, but limited data

Not all drugs which are widely approved are available everywhere. TdP: torsades de pointes, AFl: atrial flutter. Flecainide and propafenone are not available i.v. in the U.S.