[Early or delayed cardioversion in atrial fibrillation?]

Atrial fibrillation is one of the most common arrhythmias. As the symptoms can be abrupt in onset it is associated with a substantial burden on the medical emergency system. By routine practice patients with symptomatic atrial fibrillation of a duration less than 48 hours are commonly offered cardioversion therapy. Data from a recent study shows that more than two thirds of patients convert to sinus rhythm spontaneously within 48 hours. A watch-and-wait approach in rhythm control management may be suggested for clinical praxis, considering the high chance of spontaneous cardioversion. Long-term results for a group with early and delayed cardioversion were similar with regards to maintenance of sinus rhythm at 4 weeks.