Case-Based Modules > Case 23 > Conclusion

Great job! Management of a-fib is a bread-and-butter skill for inpatient neurology, with it being so common amongst our stroke patients.

Pearl 1: When your patient goes into a-fib with RVR, the decision to cardiovert hinges on whether they're hemodynamically unstable.

If they're unstable (e.g. hypotensive, demonstrating signs of shock, endorsing chest pain), then follow the ACLS algorithm and immediately perform a synchronized cardioversion.