Immediate Cardioversion or not?

I'm currently in my 5th episode of Afib in four months which began about
15 hours ago after strenuous activity.   I'm taking Calcium blockers,
ACE inhibitors for BP and Warfaran so I dont think I am in danger of stroke,  
and dont feel too bad so not so alarmed as I was in the early episodes.

Others mentioned here that they have an electro cardioversion
done as quickly as possible and I am wondering if I should pursue
that.  My question is basically how and is it advised?   Is it done
via the emergency room at the local hospital because I cannot
see how you could schedule an appt with a cardiologist on such
notice.   I dont want to go to emergency room and be admitted
for two days running up thousands of dollars of medical bills
even if insurance would pay for a lot of it.
I also want to develop a feeling for whether the electro
cardioversion is thought of as a complex and dangerous procedure
or whether done frequently as a simple routine procedure.
I've heard that depends an awful lot on whether the patient
is taking blood thinners or not as if not strokes can happen
in a hi percentage of cases.

[Michael J. McWilliams, M.D.]

My question is basically how and is it advised?  

I would start by seeing a cardiac electrophysiologist that specializes in atrial fib.  If you are having afib that frequently, you need to consider three options
1. status quo
2. anti arrhythmic drugs to help keep you out of afib (flecainide, propafenone, sotalol, dofetilide) -- first option
3. ablation (after failed trial of anti arrhythmic drugs)

Call you cardiologist first and if they can't cardiovert quickly, the ER is the next option.  Your cardiologist may direct you to the ER to get the work up started.  If  you are therapeutic on coumadin, the 48 hour rule does not apply to you and cardioversions carry a low <1% risk of stroke.

Another options -- probably the first option I would offer-- if you have a structurally normal heart and no coronary disease, is for a medication like flecainide or propafenone to take only when you go into  AF.  If you don't convert in a few hours, an electrical cardioversion is the next option.

-----also want to develop a feeling for whether the electro
cardioversion is thought of as a complex and dangerous procedure
or whether done frequently as a simple routine procedure.

Carioversions in appropriately screened patients are low risk and simple procedures.  We do them all the time.

I hope this helps.