What is the recommended approach for anticoagulation before cardioversion?
A TEE-guided approach with abbreviated anticoagulation before cardioversion has been recommended as an alternative to the conventional approach of using a minimum of 3 weeks therapeutic pre-cardioversion anticoagulation. In the TEE-guided strategy, patients receive VKA and once therapeutic, undergo a screening TEE. If the TEE identifies thrombus in either the atrial appendage or atrium, cardioversion is postponed, given the presumed high risk of thromboembolism. In the absence of thrombus, cardioversion is immediately performed.