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 .
Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation.
OBJECTIVE The aim of this study was to compare , in patients with permanent atrial fibrillation ( AF ) , the efficacy and safety of left atrial ablation with that of a biatrial procedure and to assess the risk factors for late failure of sinus rhythm restoration . METHODS Between January 2004 and January 2007 , 299 consecutive patients underwent the radiofrequency ablation procedure for AF associated with concomitant cardiac surgery .  According to a prospect i ve , open , and r and omized trial , 149 patients underwent left atrial plus cavotricuspid isthmus ablation  ( left atrial group ) , while 150 patients underwent biatrial ablation  ( biatrial group ) . The postoperative and mid-term follow-up results were compared between the two groups . Both univariate and multivariate analyses were used to assess the risk factors for late recurrence of AF . RESULTS There were seven in-hospital deaths ( 2.3 % ) , including two in the left atrial group ( 1.3 % ) and five in the biatrial group ( 3.3 % ) , and there were no differences in the incidence of the mortality and complications during the postoperative and follow-up periods between the groups . At discharge , sinus rhythm was maintained in 77.1 % of the patients , including 78.2 % of those in the left atrial group and 75.9 % in the biatrial group ( p=0.68 ) . Follow-up was completed in 97 % of the patients , with a mean time of 28+/-5 months . At the latest follow-up , two deaths occurred in the biatrial group . Sinus rhythm was documented in 237 ( 85.0 % ) out of all the patients , including 85.2 % ( 121/142 ) in the left atrial group and 84.1 % ( 116/138 ) in the biatrial group patients ( p=0.87 ) . Using a multivariate analysis , a left atrial diameter of > /=80 mm ( p=0.02 ) was an independent predictor for a late recurrence of AF . CONCLUSIONS Both the left atrial combined with cavotricuspid isthmus ablation and biatrial maze procedure is safe and effective in treating patients with AF , with an acceptable sinus conversion rate , mortality and morbidity . A left atrial dimension of > /=80 mm was a significant predictor for a late recurrence of AF
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 .