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 .
Pharmacological conversion of recent atrial fibrillation: a randomized, placebo-controlled study of three antiarrhythmic drugs.
OBJECTIVE In this study , we r and omly compared single oral doses of flecainide , amiodarone and propafenone versus placebo for the conversion of  recent atrial fibrillation ( AF ) ( within 48 hours ) . METHODS This is a r and omized prospect i ve , placebo-controlled single-blind study that included 160 consecutive patients with recent AF who were r and omly assigned to single oral doses of flecainide ( 3 mg/kg of weight , n=40 ) , amiodarone ( 30 mg/kg weight , n=40 ) , propafenone ( 8.5 mg/kg of weight , n=40 ) or placebo ( n=40 ) . The primary end-point was conversion rate at 24 hours after the drug intake . The association between antiarrhythmic use and conversion rate was tested with multiple logistic regressions . RESULTS The primary end-point was achieved in 87.5 % of patients with flecainide , 85 % of patients with amiodarone , 85 % of patients with propafenone and 17.5 % of patients with placebo ( p<0.001 compared with placebo for all 3 drugs ) . Conversion rate within 3 hours after drug intake was greater with propafenone ( 57.5 % ) or flecainide ( 45 % ) compared with amiodarone ( 0 % ) or placebo ( 10 % ) . Between 6 and 24 hours , significantly more patients were converted to sinus rhythm with amiodarone than with flecainide or propafenone . The use of antiarrhythmic drugs was a significant predictor of conversion to sinus rhythm compared to placebo ( adjusted OR=19.53 , 95 % CI 3.14 - 121.55 , p<0.001 ) . No serious side effect occurred . CONCLUSION In patients with recent-onset AF , oral flecainide , amiodarone or propafenone are superior to placebo in restoring sinus rhythm within the 24-hour period following the drug intake
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 .