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Attempt cardioversion: Heparin

Initial rate control

Attempt cardioversion: Heparin

Initial rate control

Beta blockers, oral or i.v. OR

Digoxin, i.v. or oral OR

Consider anticoagulation: * Heparin ■ Warfarin for later synchronised DC shock t, if indicated

Fig. 24.2 (continued)

Attempt cardioversion: Heparin

Flecainide 100-150 mg i.v. over 30 mins OR

Amiodarone:300 mg ¡.v. over 1 h, .may be repeated once if necessary

Synchronised DC shock t, if indicated

Initial rate control

■ Amiodarone:300 mg over 1 h, may be repeated once if necessary

AND Anticoagulation:

Later, synchronised DC shock t, if indicated

Attempt cardioversion: Heparin

Synchronised DC shock t 100 J : 200 J :360 J or equivalent biphasic energy

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