ABSTRACT
For more than 40 years, electrical cardioversion, or the discharge of electrical energy synchronized on the R wave of atrial fibrillation (AF), has been the most effective and safestmethod of restoring sinus rhythm.Only recently, new technical developments, a reappraisal of the initial energy settings, pretreatment with antiarrhythmic drugs, and a better identification of the different types of postshock recurrences have further refined the technique and improved the outcome of cardioversion. Also, our understanding of stroke risk in relation to cardioversion and the development of new antithrombotic strategies, including cardioversion guided by transesophageal echocardiography, have improved the speed and safety of cardioversion.
