Antithrombotic therapy in patients with AF in general (includes patients with permanent, per- sistent, or paroxysmal AF [PAF]) 2. Antithrombotic therapy in patients with AF in special situations: Stable coronary artery disease Acute coronary syndrome (ACS) Intracoronary artery stent Acute ischemic stroke Management with a rhythm control strategy Chronic atrial utter 3. Antithrombotic therapy for patients with AF undergoing cardioversion catheter ablation), we suggest that antithrom- botic therapy decisions follow the general risk- based recommendations for patients with AF in section 2.1, regardless of the apparent persis- tence of normal sinus rhythm (Grade 2C). 3.5. For patients with atrial utter, we sug- gest that antithrombotic therapy decisions follow the same risk-based recommendations as for AF. 4.1.1. For patients with AF of greater than 48 h or unknown duration undergoing elective electri- cal or pharmacologic cardioversion, we recom- mend therapeutic anticoagulation (adjusted-dose VKA therapy, target INR range 2.0-3.0, low- molecular-weight heparin at full venous throm- boembolism treatment doses, or dabigatran) for at least 3 weeks before cardioversion or a transesophageal echocardiography (TEE)- guided approach with abbreviated antico- agulation before cardioversion rather than no anticoagulation (Grade 1B). We recommend therapeutic anticoagulation for at least 4 weeks after successful cardioversion to sinus rhythm rather than no anticoagulation, regardless of the baseline risk of stroke (Grade 1B). Decisions about anticoagulation beyond 4 weeks should be made in accordance with our risk-based rec- ommendations for long-term antithrombotic therapy in section 2.1. 4.1.2. For patients with AF of documented duration of 48 h or less undergoing elective cardioversion (electrical or pharmacologic), we suggest starting anticoagulation at presentation (low-molecular-weight heparin or unfraction- ated heparin at full venous thromboembolism treatment doses) and proceeding to cardio- version rather than delaying cardioversion for 3 weeks of therapeutic anticoagulation or a TEE-guided approach (Grade 2C). 