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 .
Microwave Ablation in Mitral Valve Surgery for Atrial Fibrillation (MAMA).
Objective : Microwave ablation in conjunction with open heart surgery is effective in restoring sinus rhythm ( SR ) in patients with atrial fibrillation ( AF ) . In patients assigned for isolated mitral valve surgery no prospect i ve r and omized trial has reported its efficacy . Methods : 70 patients with longlasting AF where included from 5 different centres . They were r and omly assigned to mitral valve surgery and atrial microwave ablation or mitral valve surgery alone . Results : Out of 70 r and omized , 66 and 64 patients were available for evaluation at 6 and 12 months . At 12 months SR was restored and preserved in 71.0 % in the ablation group vs 36.4 % in the control group ( P=0.006 ) , corresponding figures at 6 months was 62.5 % vs 26.5 % ( P=0.003 ) . The 30-day mortality rate was 1.4 % , with one death in the ablation group vs zero deaths in the control group . At 12 months the mortality rate was 7,1 % ( Ablation n=3 vs Control n=2 ) . No significant differences existed between the groups with regard to the overall rate of serious adverse events ( SAE ) during the perioperative period or at the end of the study . 16 % of patients r and omized to ablation were on antiarrhytmic drugs compared to 6 % in the control group after 1 year ( p=0.22 ) . Conclusion : Microwave ablation of left and right atrium in conjunction with mitral valve surgery is safe and effectively restores sinus rhythm in patients with longlasting AF as compared to mitral valve surgery alone
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 .