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Aims and Objectives This study aimed to implement and evaluate a delayed cardioversion (‘wait-and-see’) strategy for hemodynamically stable patients presenting with recent-onset or paroxysmal atrial fibrillation (AF) in the emergency department (ED). AF imposes a substantial clinical and economic burden, particularly in aging populations like Ireland’s, and traditional immediate cardioversion often results in prolonged ED stays, higher admission rates, and increased procedural risks. What is new is the adoption of an evidence-based protocol aligned with the RACE 7 ACWAS trial and updated 2024 ESC guidelines to prioritize rate control, reassessment at 48 hours, and delay intervention unless necessary, optimizing patient-centered care and healthcare resource use.Method and Design A prospective audit was conducted at University Hospital Waterford between September 2023 and July 2024. Stable patients with symptomatic AF or paroxysmal AF of less than 36 hours duration were managed using a structured delayed cardioversion protocol involving initial rate control and discharge with clear instructions for scheduled reassessment after 48 hours. Chemical or electrical cardioversion was reserved for persistent cases. Outcomes monitored included spontaneous conversion rates, intervention success, safety, admission rates, and ED length of stayResults and Conclusion Out of 23 patients, 65% spontaneously converted to sinus rhythm, avoiding immediate cardioversion and hospital admission. Chemical and electrical cardioversion success rates were 38% and 100%, respectively, with no cardiovascular complications reported. ED length of stay decreased by one-third. The protocol demonstrated safety and efficacy in reducing unnecessary interventions, streamlining ED workflows, and enhancing patient care. Estimated cost savings included reduced admissions and procedural costs amounting to approximately €10,500 during the audit period, supporting broader protocol adoption in similar settings.