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 .
Quality of life and functional capacity in patients with atrial fibrillation and congestive heart failure.
OBJECTIVES This study sought to assess the impact of rhythm- versus rate-control treatment strategies and of underlying rhythm on quality of life and functional capacity in patients with atrial fibrillation ( AF ) and congestive heart failure ( CHF ) . BACKGROUND Although intention-to-treat and efficacy analyses have demonstrated similar cardiovascular outcomes in patients with AF and CHF r and omized to rhythm or rate control , effects on quality of life remain to be determined . METHODS The AF-CHF ( Atrial Fibrillation and Congestive Heart Failure ) trial r and omized 1,376 patients to rhythm- or rate-control strategies .  For this pre-specified sub study , Medical Outcomes Short Form-36 question naires were administered at baseline and 4 months . Six-min walk tests were conducted at baseline , 3 weeks , 4 months , and 1 year . RESULTS Quality of life improved across all domains to a similar extent with rhythm and rate control . However , a higher proportion of time spent in sinus rhythm was associated with a modestly greater improvement in quality of life scores . Six-min walk distance ( p = 0.2328 ) and New York Heart Association functional class ( p = 0.1712 ) improved to a similar degree with rhythm and rate control . A higher proportion of time spent in sinus rhythm was associated with a greater improvement in New York Heart Association functional class ( p < 0.0001 ) but not in 6-min walk distance ( p = 0.1308 ) . CONCLUSIONS Improvements in quality of life and functional capacity were similar in patients with AF and CHF r and omized to rhythm- versus rate-control strategies . By contrast , sinus rhythm was associated with beneficial effects on New York Heart Association functional class and modest gains in quality of life . ( Atrial Fibrillation and Congestive Heart Failure [ AF-CHF ] ; NCT88597077 )
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 .