Class IC Medications

1. Flecainide (Tambocor). A single high-bolus dose of oral flecainide (less than 400 mg within three hours) has a conversion rate of 60 to 70

percent at three hours after treatment and up to 91 percent at eight hours.

2. Propafenone (Rythmol). High-dose (600 mg) oral propafenone has a conversion rate of up to 76%.

Comparison of Antiarrhythmic Therapies

Class of agent

Agent

Dosage

Acute conversion rate

Chronic efficacy

IA

Procainamide (Procainamide injection)

10 to 15 mg per kg IV, at 25 mg per minute

20%

50%

Quinidine (Quinaglute)

324 to 648 mg PO every 8 hours

38 to 86%

47 to 60%

IC

Propafenone (Rythmol)

600 mg PO as a single bolus dose; 150 to 300 mg three times daily as a maintenance dose

51 to 76%

50 to 60%

Flecainide (Tambocor)

300 to 400 mg PO as a single bolus dose; 50 to 150 mg twice daily as a maintenance dose

68 to 91%

40 to 74%

III

Amiodarone (Cordarone)

150 mg IV over 10 minutes, then 30 to 60 mg IV per hour; 200 to 400 mg PO every day as a maintenance dose after loading

43 to 68%

55 to 65%

Sotalol (Betapace)

160 to 320 mg PO daily in two doses

20 to 52%

50 to 60%

Ibutilide (Corvert)

0.01 mg per kg IV for patients under 60 kg (132 Ib), 1 mg for patients over 60 kg, over 10 minutes

33 to 45%

N/A

Other treatment

DC cardioversion

100 to 360 joules

67 to 94%

N/A

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