Similar outcomes for Canadian vs. American strategies, despite lower admission rates in Canada
"Limit hospital admission to highly symptomatic patients in whom adequate rate control cannot be achieved"
Indications for hospitalization:
Patient with acute heart failure or hypotension after rhythm or rate control
AF secondary to hypertension, infection, COPD exacerbation, PE, ACS/MI
Age > 60 (high risk of thromboembolism, more likely to have comorbidities)
Initiation of heparin or other anticoagulant
If considering ablation of accessory pathway in patient with AF
Symptomatic recurrence in the ED
Hemodynamic instability
Indications for discharge (low-risk patients):
Discharge with urgent cardiology follow up
<60 years old
No significant comorbid disease
No clinical suspicion for PE or MI
Conversion in ED or rate control
Atrial fibrillation 
Regular
Atrial flutter
AV Node Independent
Torsades de pointes
Sinus tachycardia
Atrial tachycardia
Atrial tachycardia 