<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> ''Onset < 48 hours'' < 48 hours - heparinise if risk factors for ischaemic stroke - lifelong oral anticoagulation. also need cardioversion electrical - 'DC cardioversion' pharmacology - amiodarone if structural heart disease, flecainide in those without structural heart disease Note - if post electrical cardioversion SF confirmed as <48hrs - no need to anticoagulate ''Onset > 48 hours'' > 48 hours - anticoagulation for > 3 weeks prior to cardioversion. Else transoesophageal echo (TOE) to exclude a left atrial appendage (LAA) thrombus. If excluded patients may be heparinised and cardioverted immediately. If there is a high risk of cardioversion failure (e.g. Previous failure or AF recurrence) then it is recommend to have at least 4 weeks amiodarone or sotalol prior to electrical cardioversion Following electrical cardioversion patients should be anticoagulated for at least 4 weeks. After this time decisions about anticoagulation should be taken on an individual basis depending on the risk of recurrence