In hemodynamically stable patients with AF/AFL of known duration &lt;48 hours in whom a strategy of rhythm control has been selected:<br /><br />We recommend that rate-slowing agents alone are acceptable while awaiting spontaneous conversion. (Recommendation Strong, Quality Moderate)<br /><br />We recommend that synchronized electrical cardioversion or pharmacologic cardioversion may be used when a decision is made to cardiovert patients in the emergency department. See Table 2 for drug recommendations. (Recommendation Strong, Quality Moderate)<br /><br />We suggest that antiarrhythmic drugs may be used to pretreat patients before electrical cardioversion in ED in order to decrease early recurrence of AF and to enhance cardioversion efficacy. (Recommendation Conditional, Quality Low)<br /><br /><b>Values and preferences: </b> These recommendations place a high value on determination of the duration of AF/AFL as a determinant of stroke risk with cardioversion. Also, individual considerations of the patient and treating physician are recognized in making specific decisions about method of cardioversion.