ERDoc
Forum Asst. Chief
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The turbulent flow through the non-contracting atria cause an increased risk of forming blood clots. If you convert the rhythm and the atria start contracting normally, the clots can break lose and end up in the brain, lungs, kidneys, etc. Generally speaking, in the hospital if someone has been in afib more than 48 hours or the duration is not known we anticoagulate and control the rate. They can be safely converted once an echo has confirmed that there is no clot in the atria.