Table 1. Anti-arrhythmic drugs for the maintenance of sinus rhythm.

Drug	Route	Typical dose	Contra-indications	References
Flecainide	Oral	50–150 mg, BID	Ischaemic or structural heart disease; sinus node dysfunction, second- or thirddegree atrioventricular block or bundle branch disease without a pacemaker	20, 21
	IV	1.5–2.0 mg/ kg, over 10 min
Propafenone	Oral	150–300 mg, TID	Ischaemic or structural heart disease; asthma; sinus node dysfunction, secondor third-degree atrioventricular block or bundle branch disease without a pacemaker
	IV	1.5–2.0 mg/ kg, over 10 min
Sotalol	Oral	80–160 mg, BID	Asthma; creatinine clearance < 40 ml/min; left ventricular dysfunction; QTc > 450 ms; sinus bradycardia < 50 bpm, second- or third-degree atrioventricular block without a pacemaker	20
Amiodarone	Oral	200 mg, TID for 1 week; 200 mg, BID for 1 week; then maintenance dose of 200 mg QD	Avoid in those with advanced lung disease, severe hepatic impairment, thyroid dysfunction	21
	IV	5.0–7.0 mg/kg
Ibutilide	IV	1.0 mg over 10 min, the same dose after waiting for 10 min	Avoid in patients with QT prolongation, hypokalaemia, severe left ventricular hypertrophy or low ejection fraction	21
Dronedarone	Oral	400 mg, BID	Permanent atrial fibrillation; severe heart failure (NYHA class III–IV); QTc > 500 ms; severe hepatic impairment	17, 20