Atrial fibrillation (AF) results from the chaotic depolarization of atrial tissue and is the most common dysrhythmia diagnosed in United States (US) emergency departments. AF affects greater than 1% of the general population, with a peak prevalence of 10% in those greater than 80 years of age. By 2050, it is estimated that nearly 16 million US patients will suffer from AF. AF has significant health effects, and places a considerable economic burden on the health care system. This article discusses recommendations that are derived from a combination of existing guidelines, additional evidence, and consensus.