The Living Guidelines: Direct-current cardioversion of atrial fibrillation and atrial flutter: Polling Results for CLASS I Guidelines

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Class I Guidelines
1. When a rapid ventricular response does not respond promptly to pharmacological measures for patients with AF with ongoing myocardial ischemia, symptomatic hypotension, angina, or HF, immediate R-wave synchronized direct-current cardioversion is recommended. (Level of Evidence: C)

 ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 1 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be: CLASS I CLASS IIa CLASS IIb CLASS III 2. Immediate direct-current cardioversion is recommended for patients with AF involving pre-excitation when very rapid tachycardia or hemodynamic instability occurs. (Level of Evidence: B)

 ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 2 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be: CLASS I CLASS IIa CLASS IIb CLASS III 3. Cardioversion is recommended in patients without hemodynamic instability when symptoms of AF are unacceptable to the patient. In case of early relapse of AF after cardioversion, repeated direct-current cardioversion attempts may be made following administration of antiarrhythmic medication. (Level of Evidence: C)

 ACC / AHA 2008 guidelines for diagnosis and management of atrial fibrillation: Class I Recommendation 3 for Direct-current cardioversion of atrial fibrillation and atrial flutter should be: CLASS I CLASS IIa CLASS IIb CLASS III