If patient stable and on warfarin - do not interfere.
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NICE atrial fibrillation guidelines
Atrial fibrillation emergency resuscitation
Starting digoxin
Loading dose
15mcg per kg of estimated lean body weight, given in 3 divided doses at 6 hour intervals
eg: 50kg woman requires 750mcg = 250mcg x3 doses 6 hours apart.
If ventricular rate not slowed and no signs of toxicity, try another 5mcg per kg
Maintenance
| Creatinine clearance (ml/min) | Daily maintenance dose as a fraction of effective loading dose |
| 100 | 1/3 |
| 50 | 1/4 |
| 25 | 1/5 |
| 10 | 1/6 |
| 0 | 1/7 |
Reference: BHF factfile 7/2001