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, we recommend initiation of anticoagulation therapy with either unfractionated heparin or low-molecular-weight heparin immediately before the procedure. This is expected to reduce the risk of stroke or thromboembolism. Initiation of anticoagulation therapy should not delay any emergency interventions required in order to stabilize the patient.