[An incidental atrial fibrillation. Is the best the enemy of good?].

Atrial fibrillation (AF) is common in the elderly and often incidental. While anticoagulation is facilitated by risk-stratification scores, rate versus rhythm-control in the elderly and likely asymptomatic population remain challenging. We report an 80-year-old male with newly diagnosed slow AF, referred for an electrical cardioversion after amiodarone loading. The duration of AF and related symptoms, if any, were uncertain. Following cardioversion and despite medication cessation, the patient developed a symptomatic bradycardia with junctional rhythm prompting a pacemaker insertion. This case highlights the value of tailored care, unified judgement and the importance of considering a watchful waiting approach in selected patients.