We recommend electrical or pharmacologic cardioversion for restoration of sinus rhythm in patients with AF or AFL who are selected for rhythm-control therapy and are unlikely to convert spontaneously. (Recommendation Strong, Quality Low)<br /><br />We recommend pretreatment with antiarrhythmic drugs prior to electrical cardioversion in patients who have had AF recurrence postcardioversion without antiarrhyth- mic drug pretreatment. (Recommendation Strong, Quality Moderate)<br /><br /><b>Values and preferences: </b>These recommendations place a high value on the decision of individual patients to pursue a rhythm-control strategy for improvement in QOL and functional capacity.