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 .
Clinical assessment of clonidine in the treatment of new-onset rapid atrial fibrillation: a prospective, randomized clinical trial.
PURPOSE The role of digoxin and verapamil in the control of ventricular response in rapid atrial fibrillation is well established . This study investigates how clonidine compares with these st and ard therapies in rate control for new-onset rapid atrial fibrillation . We set out to test the hypothesis that clonidine effectively reduces heart rate in patients with new-onset rapid atrial fibrillation . SUBJECTS AND METHODS Forty patients were seen in the emergency department with new-onset ( < or = 24 hours ' duration ) , stable , rapid atrial fibrillation . Eligible patients were r and omized to receive either clonidine , digoxin , or verapamil . Changes in heart rate and blood pressure over 6 hours , as well as frequency of conversion to sinus rhythm were recorded and analyzed . RESULTS The mean reduction in heart rate over 6 hours was 44.4 beats/min ( 95 % confidence interval [ CI ] 28.4 - 60.4 beats/min ) in the clonidine group , 52.1 beats/min ( 95 % CI 40.8 - 63.4 beats/min ) in the digoxin group , and 41.8 beats/min ( 95 % CI 22.5 - 61.0 beats/min ) in the verapamil group . Analysis of variance of the heart rate changes in the 3 groups after 6 hours was not significant ( P = .55 ) . At 6 hours , 7 of 12 clonidine patients , 8 of 15 digoxin patients , and 7 of 13 verapamil patients remained in atrial fibrillation ( P = .962 on chi(2 ) ) . CONCLUSION Clonidine controls ventricular rate in new-onset atrial fibrillation with an efficacy comparable to that of st and ard agents
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 .