Summary: For adult patients with symptomatic, recent-onset, and hemodynamically stable atrial fibrillation, a “wait-and-see” approach (provision of rate control medications and follow up in approximately 48 hours with cardioversion if still in atrial fibrillation) may be associated with the same likelihood of sinus rhythm at 4 weeks, the same likelihood of hospital admission or return visits to the emergency room, but a lower likelihood of needing electrical or pharmacologic cardioversion compared to an approach of early cardioversion (either electrical or pharmacologic).

Strength of Recommendation = B