I C Urgent direct-current cardioversion of new-onset AF in the setting of ACS is recommended for patients with hemodynamic compromise, ongoing ischemia, or inadequate rate control. I C Intravenous beta blockers are recommended to slow a rapid ventricular response to AF in patients with ACS who do not display HF, hemodynamic instability, or bronchospasm. IIa B-NR If triple therapy (oral anticoagulant, aspirin, inhibitor) is prescribed for patients with AF at increased risk of stroke (based -VASc risk score of 2 or greater) who have undergone percutaneous coronary intervention (PCI) with stenting for ACS, it is reasonable to choose clopidogrel in preference to prasugrel.S7.4-4,S7.4-5 NEW: New published data are available. IIa B-R In patients with AF at increased risk of stroke (based on CHA2 -VASc risk score of 2 or greater) who have undergone PCI with stenting for ACS, double therapy with inhibitor (clopidogrel or ticagrelor) and dose-adjusted vitamin K antagonist is reasonable to reduce the risk of bleeding as compared with triple therapy.S7.4-3,S7.4-6 S7.4-8 NEW: New RCT data and data from 2 registries and a retrospective cohort study are available. IIa B-R In patients with AF at increased risk of stroke (based on CHA2 -VASc risk score of 2 or greater) who have undergone PCI with stenting for ACS, double therapy with inhibitors (clopidogrel) and low-dose rivaroxaban 15 mg daily is reasonable to reduce the risk of bleeding as compared with triple therapy.S7.4-2 NEW: New published data are available. 