A 72-year-old with symptomatic atrial fibrillation for 4 days (onset well documented) desires electrical cardioversion today. He is haemodynamically s...

Question

A 72-year-old with symptomatic atrial fibrillation for 4 days (onset well documented) desires electrical cardioversion today. He is haemodynamically stable and not anticoagulated. What is the best next step?

Accepted Answer

Perform transoesophageal echocardiography today to exclude left atrial thrombus and proceed with cardioversion with periprocedural anticoagulation

Answer

Delay cardioversion and start aspirin only

Answer

Proceed with cardioversion without anticoagulation because onset

Answer

Start rate control and avoid cardioversion for 3 months

Answer

Start warfarin and cardiovert when INR >1.5

us-abim MCQ (SBA): Atrial Fibrillation (Cardioversion)

A 72-year-old with symptomatic atrial fibrillation for 4 days (onset well documented) desires electrical cardioversion today. He is haemodynamically stable and not anticoagulated. What is the best next step?