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In catecholamine-driven AF during septic shock, AV-nodal blockers (diltiazem, esmolol) can precipitate hypotension by reducing inotropy and vasomotor tone. Amiodarone provides rate and potential rhythm control with comparatively less acute negative inotropy, allowing continuation of vasopressors while stabilizing the rhythm. Adenosine treats AVNRT/AVRT, not atrial fibrillation. Esmolol may be useful in carefully selected, monitored ICU settings after hemodynamics are secured; during transport with marginal MAP, it is risky. Start amiodarone with a standard bolus (e.g., 150 mg over 10 minutes) followed by infusion, watch QTc and interactions, and correct electrolytes (Mg²⁺, K⁺). If the patient becomes unstable (hypotension, ischemia), synchronized cardioversion is indicated. This approach aligns with CCP-C objectives: protect perfusion first, avoid iatrogenic hypotension, and choose agents compatible with shock physiology while continuously reassessing BP, mental status, urine output, lactate, and EtCO₂.