RESUMEN
For cardioversion of atrial fibrillation 2 techniques are available: pharmacological and electrical. Pharmacological cardioversion is effective, especially when the duration of arrhythmia is shorter than 7 days. In contrast, for long duration of fibrillation electrical external cardioversion is the technique of choice. The success rate ranges from 64 to 96%. The development of new defibrillators delivering biphasic waveforms is associated with an increase in the success rate of cardioversion. For patients where external cardioversion has failed, internal cardioversion should be proposed. One major concern is prevention of embolic complications. For this purpose 2 strategies are equally effective: 1.3-week anticoagulation with warfarin; 2. short-duration (2 days) heparin treatment is sufficient if the presence of a left atrial thrombus has been ruled out with a transoesophageal echocardiocardiogram.
