Atrial fibrillation (AF) is the most prevalent arrhythmia in United States. Patients with AF are at increased risk of thromboembolic events. This risk is even higher with cardioversion and ablation, especially during periprocedural period. Conventional approaches using heparin and warfarin have been successfully studied to mitigate thromboembolic risk. However, these approaches are with certain inherent limitations. The advent of new target specific oral anticoagulants (TSOAs) may overcome some of the impediments of conventional therapies and provide an alternative for anticoagulation for cardioversion and AF ablation. We will review the role of the new TSOAs in the current anticoagulation strategies to reduce the risk of thromboembolic events associated with cardioversion and AF ablation.