What is the recommended anticoagulation strategy for patients with AF and hemodynamic instability undergoing urgent cardioversion?
For patients with AF and hemodynamic instability undergoing urgent cardioversion (electrical or pharmacologic), we recommend initiating anticoagulation therapy immediately before urgent cardioversion (eg, with UFH or LMWH) to reduce the risk of stroke/thromboembolism, without delaying any emergency interventions required in order to stabilize the patient.