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 .
Randomized study comparing duty-cycled bipolar and unipolar radiofrequency with point-by-point ablation in pulmonary vein isolation.
BACKGROUND Pulmonary vein ( PV ) electrical isolation is a therapeutic option in atrial fibrillation ( AF ) . New technologies may reduce the complexity of the procedure . OBJECTIVE The aim of the present study was to compare immediate results and short-term efficacy of a new circular ablation catheter ( PVAC ) with a conventional point-by-point ablation . METHODS The prospect i ve study enrolled 80 consecutive patients with paroxysmal AF or persistent AF , refractory to antiarrhythmic drugs , who were r and omized to radiofrequency ablation using duty-cycled bipolar and unipolar radiofrequency by a decapolar circular catheter ( PVAC group ) or to point-by-point ablation supported by a 3-dimensional mapping system ( 3D group ) . RESULTS Forty patients per group were included . Mean age was 58 ± 10 years , 64 % were male ; 55 % had paroxysmal AF , 45 % had persistent AF . There were no significant differences between groups . Complete electrical isolation was reached in all but 1 PV , which was not isolated in the PVAC group because of phrenic nerve capture . Procedure and fluoroscopy times were lower in the PVAC group : 171 ± 40 minutes vs. 224 ± 27 minutes , P < .001 ; 26 ± 8 minutes vs. 35 ± 9 minutes , P < .001 ; respectively . There were no major complications . During a mean follow-up of 254 ± 99 days , 72 % in the PVAC group and 68 % in the 3D group were free of AF recurrences irrespective of the initial AF type ( P = NS ) . CONCLUSION PVAC represents a safe alternative for PV isolation . It reduces both procedure and fluoroscopy time . The short- and middle-term efficacy is comparable to a conventional point-by-point antral ablation technique
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 .