Summary

• Cardioversion to sinus rhythm should be considered for all suitable patients in atrial fibrillation

• In the short term both pharmacological and electrical cardioversion restore sinus rhythm

• Prophylactic treatment with antiarrhythmic drugs is advisable after cardioversion in high risk patients in view of the high relapse rate

• Anticoagulants should be started before non-emergency cardioversion—ideally two to three weeks before—and continued for at least four weeks after cardioversion in patients with atrial fibrillation of >48 hours' duration