Which medication can be utilized for chemical cardioversion in atrial fibrillation?

In the context of atrial fibrillation, chemical cardioversion refers to the use of medication to restore normal sinus rhythm. Adenosine is specifically effective in this role as it works rapidly to interrupt the conduction pathway through the atrioventricular (AV) node, leading to a transient block. This can reset the heart rhythm in cases of certain supraventricular tachycardias, including some instances of atrial fibrillation, especially when used acutely.

While amiodarone is also used to manage atrial fibrillation and can help in achieving a rhythm control, it is not primarily recognized for acute cardioversion due to its slower onset of action and longer half-life. Digoxin is primarily used for rate control rather than for cardioversion. Diltiazem, a calcium channel blocker, is beneficial for controlling ventricular rate during atrial fibrillation but is not typically used for converting the rhythm back to normal.

Therefore, adenosine is the drug of choice among the options for achieving chemical cardioversion in atrial fibrillation due to its rapid action on the AV node, making it effective in rapidly converting certain types of atrial arrhythmias back to normal sinus rhythm.