When is cardioversion indicated in the treatment of atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

For atrial flutter duration shorter than 48 hours, attempt cardioversion as soon as possible. Similar to patients with atrial fibrillation, a decision on the need for postconversion anticoagulation is made after considering the individual patient’s risks of thromboembolism and bleeding. Data from transesophageal echocardiography (TEE) studies indicate that postconversion anticoagulation is recommended because appendage blood flow velocity is lowest immediately after conversion and recovers slowly.


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