Frequently, I observe hospitalized patients who exhibit first-time paroxysmal atrial fibrillation that lasts less than 24-48 hours then spontaneously converts. What is your cut-off time for branding a patient with life-long anticoagulation? If a hospitalized patient with a CHADS2Vasc of >=2 develops first-time paroxysmal atrial fibrillation for less than 5 minutes, would you recommend lifelong anticoagulation if they have no contraindication? Would your recommendation change if the atrial fibrillation was provoked by sepsis?
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