Letters21 December 1999Cost-Effectiveness of Therapy in Nonatrial FibrillationEdward Catherwood, MD, MS and Mark L. Greenberg, MDEdward Catherwood, MD, MSDartmouth-Hitchcock Medical Center; Lebanon, NH 03756 (Catherwood)Dartmouth-Hitchcock Medical Center; Lebanon, NH 03756 (Greenberg)Search for more papers by this author and Mark L. Greenberg, MDDartmouth-Hitchcock Medical Center; Lebanon, NH 03756 (Catherwood)Dartmouth-Hitchcock Medical Center; Lebanon, NH 03756 (Greenberg)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-12-199912210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Wiesel argues that all patients with nonvalvular atrial fibrillation should receive long-term anticoagulation after successful cardioversion. He cites the frequent association of paroxysmal or chronic atrial fibrillation with acute stroke (1). He also raises concern that our estimate of early stroke risk (a 6-week fraction of the annualized risk) if relapse occurs is too low, given the potential for paroxysmal episodes. He refers to the study by Lin and colleagues (1), which examined the frequency of newly diagnosed atrial fibrillation in patients presenting with acute stroke. This study did not assess the occurrence of stroke in patients ...