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 trial of prophylactic antiarrhythmic agents (amiodarone and sotalol) in patients with atrial fibrillation for whom direct current cardioversion is planned.
UNLABELLED Antiarrhythmic agents enhance maintenance of sinus rhythm ( SR ) after direct current cardioversion ( DCC ) for atrial fibrillation but there are few comparative trials . BACKGROUND The aims of the study were ( 1 ) to establish whether patients successfully cardioverted to SR are more likely to stay in SR over 6 months if taking amiodarone or sotalol , and if so , to establish whether one agent is better than the other ; ( 2 ) to establish whether taking amiodarone or sotalol is better at achieving chemical cardioversion within the 6 weeks before DCC ; and ( 3 ) to establish whether DCC is more likely to be successful on a drug . METHODS R and omized , prospect i ve , nonblinded , controlled study of treatment with either amiodarone ( n = 27 ) , sotalol ( n = 36 ) , or no antiarrhythmic agent ( n = 31 ) . RESULTS Chemical cardioversion occurred in 7 patients in the amiodarone group ( A ) , 7 patients in the sotalol group ( S ) , but none in the no-antiarrhythmic group ( N ) . A total of 33 ( 92 % ) patients in the sotalol group , 22 ( 81 % ) patients in the amiodarone group , and 23 ( 74 % ) patients in the no-antiarrhythmic group were in SR after cardioversion . Of the original cohort of patients , 17 ( 63 % ) patients in the amiodarone group remained in SR at 6-month follow-up , compared with 14 ( 39 % ) in the sotalol group and 5 ( 16 % ) in the no-antiarrhythmic group ( A vs N , P < .0002 , P < .0006B [ after Bonferroni correction ] ; A vs S , P = .05 , P = .15B ; and S vs N , P = .03 , P = .09B ) . CONCLUSIONS Amiodarone and sotalol achieved chemical cardioversion before planned electrical cardioversion in 26 % and 19 % of patients , respectively . After successful cardioversion , amiodarone appears better than sotalol at maintaining SR at 6 months
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 .