Situations in which rhythm control is preferable:
- failure of rate control
- heart failure
- younger patients (less than 65 years)
- patients early in their natural history
We consider cardioversion to SR in most patients (particularly younger patients) with a first episode of AF in whom the arrhythmia is of recent onset and the risk for recurrence appears to be low based upon the following findings:
- Left atrial dimension less than 4.5 to 5 cm.
- A reversible underlying disorder such as hyperthyroidism, pericarditis, pulmonary embolism, or postoperative AF.
- Absence of hypertension.
- Normal left ventricular systolic function.
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