Question

A 60-year-old with nonvalvular AF and CHA2DS2-VASc 4 on apixaban asks about cardioversion for symptomatic persistent AF. What is recommended regarding anticoagulation?

Accepted Answer

Ensure therapeutic anticoagulation for at least 3 weeks before and 4 weeks after cardioversion (or TEE-guided)

Answer

Stop anticoagulation 24 hours prior

Answer

Anticoagulate only for 48 hours post-cardioversion

Answer

Anticoagulation unnecessary if asymptomatic

Answer

Use aspirin instead

Practice question

A 60-year-old with nonvalvular AF and CHA2DS2-VASc 4 on apixaban asks about cardioversion for symptomatic persistent AF. What is recommended regarding anticoagulation?