Box 1.

Emergency cardioversion

Patients who present with adverse features – such as haemodynamic compromise, syncope, mycocardial ischaemia or acute pulmonary oedema – that are believed to be as a result of, or exacerbated by, the patient’s atrial fibrillation should receive urgent cardioversion regardless of the duration of atrial fibrillation or anticoagulation status.1,2 All patients who receive emergency cardioversion should be anticoagulated for a minimum of 4 weeks afterwards if no contraindications.2