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 .
Acute beta-adrenoceptor blockade improves efficacy of ibutilide in conversion of atrial fibrillation with a rapid ventricular rate.
AIMS Activation of beta-adrenoceptors attenuates prolongation of action potential duration induced by blockade of the delayed rectifier potassium current . We examined whether acute administration of beta-blocker could enhance ibutilide ( IB ) efficacy in conversion of atrial fibrillation ( AF ) with a rapid ventricular rate . METHODS AND RESULTS Ninety patients ( aged 63 + /- 13.5 years ) with rapidly conducting AF were r and omized in to two groups . Group A ( n = 44 ) received esmolol titrated to achieve a heart rate of < 100 bpm followed by IB co-administration , while Group B ( n = 46 ) were treated with IB as monotherapy . In Group A , 29 patients ( 67 % ) converted to sinus rhythm ( SR ) compared with 21 ( 46 % ) in Group B ( P = 0.04 ) . The use of esmolol was the most important predictor for cardioversion ( P = 0.009 ) . The slower the heart rate at the time of IB initiation , the higher the likelihood for cardioversion ( P = 0.015 ) . Patients in Group A had significantly shorter corrected QT interval ( QTc ) at the time of conversion than those in Group B ( 433 vs. 501 ms , P = 0.003 ) . Two patients in Group A developed severe bradycardia , whereas three patients in Group B developed severe ventricular tachycardia ( VT ) . CONCLUSION Compared with IB monotherapy , the combination therapy of esmolol and IB appears to be more effective in conversion of rapidly conducting AF back to SR . The addition of beta-blocker reduces QTc prolongation and diminishes the risk of VT at the expense , however , of increased bradycardic events
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 .