Would you consider amiodarone for the treatment of atrial fibrillation with RVR in patients who cannot tolerate beta blockers but have a high CHA2DS2-VASc score and are not on anticoagulation?

We typically do not due to risk of chemical cardioversion and precipitating an embolism.

"Blind" cardioversion in this scenario is risky due to thromboembolic potential. Furthermore, amiodarone is a "dirty drug" with a very long half-life and can affect multiple organs concurrently (lungs, eyes, thyroid, etc). Thus, the decision to use should be carefully weighed and discussed with the ...

INDICATIONS AND USAGE Because of its life-threatening side effects and the substantial management difficulties associated with its use (see “WARNINGS” below), Cordarone is indicated only for the treatment of the following documented, life-threatening recurrent ventricular arrhythmias when these have...