What is the recommendation for patients with AF of documented duration of 48 h or less undergoing elective cardioversion?
For patients with AF of documented duration of 48 h or less undergoing elective cardioversion (electrical or pharmacologic), it is suggested to start anticoagulation at presentation (low-molecular-weight heparin or unfractionated heparin at full venous thromboembolism treatment doses) and proceed to cardioversion rather than delaying cardioversion for 3 weeks of therapeutic anticoagulation or a TEE-guided approach (Weak recommendation, low quality evidence). 