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Atrial Fibrillation 2023 Update

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84 Management Proceed with cardioversion (See section 10.9) (2a) Figure 21. Patients With Hemodynamically Stable AF Planned for Cardioversion Anticoagulate for at least 3–6 wk and repeat imaging to confirm resolution of thrombus before cardioversion (1) Role of pericardioversion anticoagulation uncertain Therapeutic pericardioversion anticoagulation may be considered (2b) No intracardiac thrombus noted intraop and postop AF ascertained at <48 h Imaging to assess adequacy of occlusion and exclude intracardiac thrombus (including device-related thrombus) before cardioversion (2b) Imaging to exclude intracardiac thrombus before cardioversion (See section 10.9) (2a) Not on AC AF in postcardiac surgery setting? (See section 10.9) Prior LAAO? Intracardiac thrombus? Does imaging show intracardiac thrombus? YES YES YES NO NO YES YES YES NO NO YES NO Does imaging show residual leak?

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