A wait-and-see approach is not inferior to immediate cardioversion in people who come to the emergency department with recent-onset atrial fibrillation, researchers say.

In two-thirds of the cases, the atrial fibrillation resolves without treatment, they found.

“Delayed cardioversion with longer time spent in atrial fibrillation could promote stroke, but timely, guideline-based initiation of anticoagulation is expected to reduce the risk of stroke,” the researchers said.

The study was performed at 17 EDs in the Netherlands in an attempt to determine if immediate restoration of sinus rhythm is necessary in haemodynamically stable patients.