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Figure 1 A diagram illustrating the Assessment of Cardioversion Using Transesophageal Echocardiography trial (ACUTE) protocol. Patients were randomly assigned to either a transesophageal echocardiography (TEE)-guided or conventional group; TEE-guided patients, without thrombus by TEE, received early cardioversion with short-term therapeutic anticoagulation. Transesophageal echocardiography-guided patients with thrombus received three weeks anticoagulation and repeat TEE. Conventional patients received no TEE and three weeks anticoagulation before cardioversion. All patients received four weeks of therapeutic anticoagulation after cardioversion. DCC = direct current cardioversion.