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 .
A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery.
AIM Mitral valve surgery seldom suppresses  atrial fibrillation ( AF )  , present prior to surgery . Maze III surgery eliminates AF in > 80 % of cases , the reason why combining this procedure with mitral valve surgery in patients with AF seems worthwhile . We prospect ively studied the outcome of combining the Maze III procedure with mitral valve surgery . METHODS Thirty-five patients with AF and a mean age of 64 years undergoing mitral valve surgery were prospect ively r and omized according to a 2.5:1 ratio to surgery with ( n=25 ) , or  without ( n=10 ) maze III  and followed for at least 1 year . RESULTS At discharge and after 12 months freedom from AF was 56 % and 92 % , respectively , in the maze group , and 0 % and 20 % , respectively , in patients without maze ( group differences at discharge p=0.002 , after 12 months p=0.0007 ) . Sinus node incompetence was seen in 1 of 25 maze patients requiring pacing . No in-hospital or late death occurred ; stroke was observed in 1 patient ( without maze ) . Quality of life markedly improved after surgery , but did not differ between patients with or without maze surgery . CONCLUSIONS This first prospect i ve r and omized study shows that combining maze III with mitral valve surgery result ed in a significantly better elimination of preoperative AF than mitral valve surgery alone . As the quality of life did not differ between patients with , or without maze surgery , additional maze surgery is primarily recommended in patients in whom anticoagulation therapy can be avoided after surgery , specifically in patients with scheduled mitral valve plasty
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 .