What are the ACCP anticoagulation recommendations for persistent 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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In general, when atrial flutter persists for longer than 48 hours, 4 weeks of adequate anticoagulation must be provided or the absence of thrombus on TEE documented before attempting cardioversion to sinus rhythm. Postconversion anticoagulation is recommended for a minimum of 4 weeks, because thromboembolic complications can occur spontaneously after cardioversion or ablation. (Grade 1B)

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