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 .
Left ventricular-based cardiac stimulation post AV nodal ablation evaluation (the PAVE study).
BACKGROUND Chronic right ventricular pacing has been reported to promote cardiac dyssynchrony . The PAVE trial prospect ively compared chronic biventricular pacing to right ventricular pacing in patients undergoing ablation of the AV node for management of atrial fibrillation with rapid ventricular rates . METHODS AND RESULTS One hundred and eighty-four patients requiring AV node ablation were r and omized to receive a biventricular pacing system ( n = 103 ) or a right ventricular pacing system ( n = 81 ) . The study endpoints were change in the 6-minute hallway walk test , quality of life , and left ventricular ejection fraction .  Patient characteristics were similar ( 64 % male ; age : 69 + /- 10 years , ejection fraction : 0.46 + /- 0.16 ; 83 % , NYHA Class II or III ) . At 6 months postablation , patients treated with cardiac resynchronization had a significant improvement in 6-minute walk distance , ( 31 % ) above baseline ( 82.9 + /- 94.7 m ) , compared to patients receiving right ventricular pacing , ( 24 % ) above baseline ( 61.2 + /- 90.0 m ) ( P = 0.04 ) . There were no significant differences in the quality -of-life parameters . At 6 months postablation , the ejection fraction in the biventricular group ( 0.46 + /- 0.13 ) was significantly greater in comparison to patients receiving right ventricular pacing ( 0.41 + /- 0.13 , P = 0.03 ) . Patients with an ejection fraction < or=45 % or with NYHA Class II/III symptoms receiving a biventricular pacemaker appear to have a greater improvement in 6-minute walk distance compared to patients with normal systolic function or Class I symptoms . CONCLUSION For patients undergoing AV node ablation for atrial fibrillation , biventricular pacing provides a significant improvement in the 6-minute hallway walk test and ejection fraction compared to right ventricular pacing . These beneficial effects of cardiac resynchronization appear to be greater in patients with impaired systolic function or with symptomatic heart failure
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 .