Scheuermeyer FX, et al. - Researchers investigated the comparative effectiveness of chemical-first and electrical-first strategies for emergency department (ED) patients with uncomplicated atrial fibrillation (AF) of less than 48 hours. At six urban Canadian centers, they randomized 84 eligible patients: 41 in the chemical-first group in which they performed chemical cardioversion with procainamide infusion, that was followed by electrical countershock if unsuccessful; and 43 in the electrical-first group, in which they performed electrical cardioversion, that was followed by procainamide infusion if unsuccessful. As per outcomes, both chemical-first and electrical-first strategies appear efficacious and safe for uncomplicated ED AF patients managed with rhythm control; however, there was a significantly shorter ED length-of-stay when an electrical-first strategy was employed.