Afib tx algorithm

Afib. Hemodynam unstable? Shock it. Hemodynam stable? Use rate control (like BB or CCB) If shorter than 48h, cardiovert (chem or electrically) If longer than 48 h, enough time has passed we're seriously worried about a clot or thromboembolus in the left atrial appendage. So either get a TEE or anticoagulate for 3 weeks, then cardiovert patient.