The duration of post-cardioversion anticoagulation should be
dictated by the likely timing of the return of normal LA/LAA
function and the likelihood of maintaining sinus rhythm. If atrial
fibrillation has been present for several days only, normal atrial
function will usually be re-established over a similar period and
intravenous heparin for a few days post-cardioversion is probably
adequate. Where the duration of AF is longer or unknown a period
of anticoagulation with warfarin for 1–3 months is advised
(reflecting a slower time course of recovery of atrial function).
FFuurrtthheerr rreeaaddiinngg
Black IW, Fatkin D, Sagar KB et al. Exclusion of atrial thrombus by trans-
oesoophageal echocardiography does not preclude embolism after
cardioversion of atrial fibrillation. A multicenter study. Circulation
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Hardman SM, Cowie M. Fortnightly review: anticoagulation in heart
disease. BMJ1999; 331188 : 238–44 (website version at http://www.bmj.com)..)
Stoddard MF, Dawkins PR, Prince CR et al. Left atrial appendage
thrombus is not uncommon in patients with acute atrial fibrillation and a
recent embolic event; a transoesophageal echocardiographic study. J Am
Coll Cardiol1995; 2255 : 452–9.