Economic implications of transesophageal echocardiography-guided cardioversion of atrial fibrillation.

schemic stroke is the most feared complication of atrial brillation, and many studies have investigated strategies to educe cerebral embolism. Anticoagulation with warfarin is emarkably effective in reducing the risk of ischemic stroke mong patients with chronic atrial fibrillation (1) and has ecome standard therapy. More recently, four randomized rials (2–5) have shown that a strategy of aggressive rhythm ontrol was no better than a strategy of rate control in reventing ischemic stroke and other adverse clinical outomes. Many of the ischemic strokes in patients assigned to he rhythm control strategy in these trials occurred after ormal sinus rhythm had been re-established and anticoaglation had been discontinued.