Article: Quinidine for cardioversion of AF.

The "Stat consult" on atrial fibrillation (AF) (September 2005) by Brian S. Alper, MD, MSPH, and Roger Garvin, MD, was almost complete. The authors mentioned that digoxin is ineffective for AF, which certainly is true, but did not note that a combination of digoxin and quinidine sulfate will convert most patients without all the fuss of other approaches mentioned. I give 0.5 mg of digoxin on day one, then drop it to 0.25 mg every day thereafter. On day two, I add quinidine sulfate 200 mg four times daily. If the patient has not converted by the fourth or fifth day, I push the quinidine to 400 mg four times daily. If nothing happens after about a week, I obtain digoxin and ...

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