Management of atrial fibrillation includes assessing the need for rate control, identifying underlying conditions, and performing cardioversion or instituting long-term medical therapy. Elective cardioversion should be strongly considered for every patient, chiefly to decrease the incidence of embolic stroke. Patients who remain in chronic atrial fibrillation require attention to rate control; digoxin (Lanoxin) alone may be a poor choice if they are vigorous and active. Many subgroups of patients benefit from long-term anticoagulation.