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357 patients(95.2%)converted to sinus rhythm during the index admission; spontaneous conversion occurred in 250 patients(66.7)and active pharmacologic or electrical conversion was done in 107 patients(28.5%). Three patients,all of whom had converted spontaneously after ventricular rate control was begun,had a clinical thromboembolic event;One had a stroke,one had a transient ischemic attach and one had a peripheral embolus.None of these three patients had a history of atrial fibrillation or thromboembolism and all had normal left ventricular systolic function. Among patients presenting with atrial fibrillation that was clinically estimated to have lasted less than 48 hours,the likelihood of cardioversion-related clinical thromboembolism is low.These data support the current recommendation for early cardioversion in these patients. |
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