D. Restoration of sinus rhythm for monophasic vs. biphasic waveforms .
Another study showed that PVI result ed in long-term restoration
Atrial fibrillation ( AF ) is a major public health problem in the United States .
More than 2.3 million Americans are estimated to have AF ( 1 ) .
The known association between AF and substantial mortality , morbidity , and health care costs compounds the effect of this condition .
Not only is the risk for death in patients with AF twice that of patients without it , but AF can result in myocardial ischemia and infa rct ion , exacerbate heart failure ( HF ) , and cause tachycardia-induced cardiomyopathy if the ventricular rate is not well-controlled ( 25 ) .
The most dreaded complication of AF is thromboembolism , especially stroke ( 6 ) .
In some patients , AF or therapies to manage this condition can severely depreciate quality of life ( 710 ) .
Furthermore , the management of AF and its complications is responsible for nearly $ 16 billion in additional costs to the U.S. health care system per year ( 11 ) .
We conducted this systematic review to evaluate the comparative safety and effectiveness of rate- versus rhythm-control strategies ;  medications used for ventricular rate control ; strict versus more lenient rate-control strategies ; nonpharmacologic rate-control therapies  versus medications ; electrical cardioversion and antiarrhythmic medications  for restoration of sinus rhythm ;  and  catheter ablation , surgical ablation , and antiarrhythmic medications  for maintenance of sinus rhythm .
Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results.
OBJECTIVE The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency ( RF ) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results . MATERIAL AND METHOD During a 16 months time period , 67 patients with chronic atrial fibrillation ( AF ) eligible for port access mitral valve surgery  were r and omly assigned to either Group A , in which they underwent a combined procedure ( N = 33 ) or Group B , in which a valve procedure alone was performed ( N = 34 ) . Both groups were similar in terms of age , sex , valve pathology , duration of AF left atrial diameter and left ventricle function ( P > 0.05 ) . Four had undergone previous operations . RESULTS Median follow-up was 10 months for both groups , 95 % CI ( 9.18 - 10.8 ) . One patient in each group died early postoperatively ( 3 and 2.9 % ) . Two patients required reoperation for bleeding , one in each group ( 3 and 2.9 % ) . There were two conversions to right thoracotomy . In Group A , freedom from AF was 100 % at the end of the operation ( 76 % sinus , 24 % pacemaker ) Six and twelve months freedom from AF was 87.2 and 93.6 % , respectively . In Group B , freedom from AF at the end of operation was 41 % . At the end of 6 and 12 months , freedom from AF was 9.4 % ( P = 0.0001 ) . One patient in Group A required a permanent pacemaker ( 3 % ) . During follow-up , one patient in Group A died of non-cardiac causes ( 3 % ) . In Group B , there were two late deaths : one cardiac ( 2.9 % ) and one neurologic ( 2.9 % ) . There were no thromboembolic events detected in Group A during follow-up , whereas two patients in Group B suffered this complication ( 6 % , P = 0.081 ) . At 12 months , functional capacity had improved for patients in both groups ( P < 0.0001 ) . CONCLUSION The combination of mitral valve surgery and irrigated RF Maze procedure was safe and efficient through a port access approach . There were no procedure related complications like esophageal or coronary artery injury . Early and mid-term results were favourable with 93.6 % of patients free of AF at 1 year in comparison to the 9.4 % of the control group . The data is not sufficient to reach any conclusions in terms of thromboembolic rates , despite favourable results for the RF Maze group . Nevertheless , in terms of feasibilty , sinus rhythm restoration and overall outcome , early results are encouraging and we advocate the use of the combined procedure through a port access approach
D. Restoration of sinus rhythm for monophasic vs. biphasic waveforms .
Another study showed that PVI result ed in long-term restoration
Atrial fibrillation ( AF ) is a major public health problem in the United States .
More than 2.3 million Americans are estimated to have AF ( 1 ) .
The known association between AF and substantial mortality , morbidity , and health care costs compounds the effect of this condition .
Not only is the risk for death in patients with AF twice that of patients without it , but AF can result in myocardial ischemia and infa rct ion , exacerbate heart failure ( HF ) , and cause tachycardia-induced cardiomyopathy if the ventricular rate is not well-controlled ( 25 ) .
The most dreaded complication of AF is thromboembolism , especially stroke ( 6 ) .
In some patients , AF or therapies to manage this condition can severely depreciate quality of life ( 710 ) .
Furthermore , the management of AF and its complications is responsible for nearly $ 16 billion in additional costs to the U.S. health care system per year ( 11 ) .
We conducted this systematic review to evaluate the comparative safety and effectiveness of rate- versus rhythm-control strategies ;  medications used for ventricular rate control ; strict versus more lenient rate-control strategies ; nonpharmacologic rate-control therapies  versus medications ; electrical cardioversion and antiarrhythmic medications  for restoration of sinus rhythm ;  and  catheter ablation , surgical ablation , and antiarrhythmic medications  for maintenance of sinus rhythm .