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 .
Does intensity of rate control influence outcome in persistent atrial fibrillation? Data of the RACE study.
BACKGROUND Large trials have demonstrated that rate control is an acceptable alternative for rhythm control . However , optimal heart rate during atrial fibrillation ( AF ) remains unknown . Aim of this analysis was to compare outcome between rate control > or = 80 and < 80 beat/min in patients with persistent atrial fibrillation . METHODS In the RAte Control versus Electrical cardioversion for persistent atrial fibrillation study , 522 patients were included , and 256 were r and omized to rate control . This post hoc analysis included patients r and omized to rate control . Patients were divided according to their mean resting heart rate during follow-up , < 80 beat/min ( n = 75 ) or > or = 80 beat/min ( n = 139 ) . The end point , a composite of cardiovascular mortality , heart failure , thromboembolic complications , bleeding , pacemaker implantation , and severe drug side effects , was compared between both groups . RESULTS During follow-up ( 2.3 + /- 0.6 years ) , a significant difference between both groups in heart rate was observed ( 72 + /- 5 vs 90 + /- 8 beat/min ; P < .001 ) . Rate control drugs were not significantly different between both groups . New York Heart Association class and fractional shortening remained unchanged in both groups . There were 17 ( 23 % ) end points in the low heart rate group and 24 ( 17 % ) in the higher heart rate group ( absolute difference , 5.4 [ -7.3 to 8.2 ] ; P = ns ) . Independent predictors for the primary end point were coronary artery disease , digoxin use , and interrupted anticoagulation , not high heart rate . Quality of life was comparable in both groups during follow-up . CONCLUSIONS In patients treated with a rate control strategy  , no differences were observed in terms of cardiovascular morbidity , mortality , and quality of life between the observed differences in level of rate control throughout follow-up
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 .