Abstract
Atrial fibrillation significantly increases the risk of stroke or systemic embolism. Antithrombotic treatment should be applied according to the individual stroke risk irrespective of whether a rate control or rhythm control strategy had been implemented. Simple risk stratification scores are available to assess the individual stroke risk in daily practice. Cardioversion of atrial fibrillation is associated with an increased stroke risk due to a transient mechanical atrial dysfunction referred to as „atrial stunning“. According to current guidelines, an effective anticoagulation for 4 weeks after cardioversion is recommended in all patients with an atrial fibrillation episode lasting longer than 48 hours or of unknown duration and in patients with an atrial fibrillation episode less than 48 hours and risk factors for stroke. Since cardioversion does not prevent atrial fibrillation recurrences, long-term anticoagulation should be guided by the individual stroke risk.
