Recent evidence suggests that delayed cardioversion of uncomplicated acute AF is non-inferior to early cardioversion in the Emergency Department (ED), 1 Pluymaekers N.A.H.A. Dudink E.A.M.P. Luermans J.G.L.M. et al. Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation. N Engl J Med. 2019; 380: 1499-1508 Crossref PubMed Scopus (95) Google Scholar and most patients will revert spontaneously to sinus rhythm (SR) by a rate control strategy. 2 Abadie B.Q. Hansen B. Walker J. et al. Likelihood of Spontaneous Cardioversion of Atrial Fibrillation Using a Conservative Management Strategy Among Patients Presenting to the Emergency Department. Am J Cardiol. 2019; 124: 1534-1539 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar We adopted a new inter-departmental acute AF clinical pathway 3 Al-Busaidi I.S. Clare G.C. Joyce L.R. et al. Presentation, Treatment and Long-Term Outcomes of a Multidisciplinary Acute Atrial Fibrillation Pathway: A 12-Month Follow-Up Study. Heart Lung Circ. 2022; 31: 216-223 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar in 2015 which involves a ‘rate-and-wait’ strategy where patients are managed with rate control agents followed by a review in a ward-based clinic within 24-72 hours (97% attend within this time frame). Over two-thirds (71%) of pathway patients spontaneously reverted to SR by clinic review. 3 Al-Busaidi I.S. Clare G.C. Joyce L.R. et al. Presentation, Treatment and Long-Term Outcomes of a Multidisciplinary Acute Atrial Fibrillation Pathway: A 12-Month Follow-Up Study. Heart Lung Circ. 2022; 31: 216-223 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar We examined predictors of spontaneous reversion to SR at AF clinic follow-up.