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https://en.wikipedia.org/wiki/management_of_atrial_fibrillation#:~:text=Management%20of%20atrial%20fibrillation.%20Cardioversion%20is%20indicated%20with,electrophysiological%20studies%20with%20ablation%20of%20abnormal%20electrical%20pathways.
https://pubmed.ncbi.nlm.nih.gov/28974590/
Current guidelines support the well-established clinical practice that patients who present with atrial fibrillation (AF) of less than 48 hours duration should be considered for cardioversion, even in the absence of pre-existing anticoagulation. However, with increasing evidence that short runs of AF confer significant risk of stroke, on what evidence is this 48-hour rule based and is it …
https://www.rcpjournals.org/content/clinmedicine/17/5/419
International guidelines support the well-established clinical practice that patients who present with non-valvular atrial fibrillation (AF) of less than 48 hours duration should be considered for cardioversion, even in the absence of pre-existing anticoagulation. 1,2 The risk with more prolonged periods of AF is that restoration of sinus rhythm may precipitate …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301939/
International guidelines support the well-established clinical practice that patients who present with non-valvular atrial fibrillation (AF) of less than 48 hours duration should be considered for cardioversion, even in the absence of pre-existing anticoagulation. 1,2 The risk with more prolonged periods of AF is that restoration of sinus rhythm may precipitate embolism of intra …
https://www.practicalcardiology.com/view/afib-less-48-hours-look-thromboembolic-risk
Firstly, the CHA 2 DS 2-Vasc risk score estimator provides relatively good risk estimation even in patients undergoing cardioversion with short duration of AF. Secondly, caution should be exercised in patients with a CHA 2 DS 2-Vasc >2 undergoing cardioversion when AF duration is <48 hours. Although larger studies are needed to validate these findings (as the …
https://pubmed.ncbi.nlm.nih.gov/29759870/
Incidence of Thromboembolic Complications Within 30 Days of Electrical Cardioversion Performed Within 48 Hours of Atrial Fibrillation Onset. JACC Clin Electrophysiol. 2016 Aug;2 (4):487-494. doi: 10.1016/j.jacep.2016.01.018. Epub 2016 Apr 6.
https://jamanetwork.com/journals/jama/fullarticle/1895235
In 1995, practice guidelines recommended a limit of 48 hours after the onset of atrial fibrillation (AF) for cardioversion without anticoagulation. 1-3 Whether the risk of thromboembolic complications is increased when cardioversion without anticoagulation is performed in less than 48 hours is unknown.
http://www.emlitofnote.com/?p=3393
It has become generally accepted practice to treat new-onset atrial fibrillation and atrial flutter with electrical cardioversion in the acute setting – provided the known onset of atrial fibrillation is less than 48 hours.
https://www.uptodate.com/contents/atrial-fibrillation-cardioversion#!
Garg A, Khunger M, Seicean S, et al. Incidence of Thromboembolic Complications Within 30 Days of Electrical Cardioversion Performed Within 48 Hours of Atrial Fibrillation Onset. JACC Clin Electrophysiol 2016; 2:487.
https://www.nejm.org/doi/full/10.1056/NEJMoa1900353
The wait-and-see approach involved initial treatment with rate-control medication only and delayed cardioversion if the atrial fibrillation did not resolve within 48 hours.
https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2019/2019-Afib-Guidelines-Made-Simple-Tool.pdf
For patients with AF or atrial flutter of 48 hours’ duration or longer, or when the duration of AF is unknown, anticoagulation with warfarin (INR 2.0 to 3.0), a factor Xa inhibitor, or direct thrombin inhibitor is recommended for at least 3 weeks before and at least 4 weeks after cardioversion. Change in Guideline Recommendations (Only major included)
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