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 .
Effects of a high dose intravenous bolus amiodarone in patients with atrial fibrillation and a rapid ventricular rate.
BACKGROUND Amiodarone , given as intravenous bolus has not yet been studied in patients with atrial fibrillation and a high ventricular rate . METHODS One hundred consecutive patients with atrial fibrillation and a ventricular rate above 135 bpm were r and omized to receive either 450 mg amiodarone or 0.6 mg digoxin given as a single bolus through a peripheral venous access . If the ventricular rate exceeded 100 bpm after 30 min , another 300 mg amiodarone or 0.4 mg digoxin were added . Primary endpoints of the study were the ventricular rate and the occurrence of sinus rhythm after 30 and 60 min . Secondary endpoints were blood pressure during the first hour after drug administration , and safety regarding drug induced hypotension , and phlebitis at the infusion site . RESULTS Baseline heart rate was 144+/-19 in the amiodarone group and 145+/-15 in the digoxin group ( p=0.72 ) . Following amiodarone , heart rate was 104+/-25 after 30 min compared to 116+/-23 in the digoxin group ( p=0.02 ) and 94+/-22 versus 105+/-22 after 60 min ( p=0.03 ) . After 30 min , sinus rhythm was documented in 14 ( 28 % ) patients following amiodarone compared to 3 ( 6 % ) patients in the digoxin group ( p=0.003 ) , and after 60 min in 21 ( 42 % ) versus 9 ( 18 % ) patients ( p=0.012 ) . Asymptomatic hypotension was observed in 4 amiodarone treated patients , and superficial phlebitis in 1 patient . CONCLUSIONS Amiodarone , given as an intravenous bolus is relatively safe and more effective than digoxin for heart rate control and conversion to sinus rhythm in patients with atrial fibrillation and a rapid ventricular rate
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 .