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 .
Impact of systematic isolation of superior vena cava in addition to pulmonary vein antrum isolation on the outcome of paroxysmal, persistent, and permanent atrial fibrillation ablation: results from a randomized study.
BACKGROUND Pulmonary veins ( PVs ) have been shown to represent the most frequent sites of ectopic beats initiating paroxysmal atrial fibrillation ( AF ) . However , additional non-PV triggers , arising from different areas , have been reported as well . One of the most common non-PV sites described is the superior vena cava . AIMS The purpose of the study was to investigate the impact result ing from the systematic isolation of the superior vena cava ( SVCI ) in addition to pulmonary vein antrum isolation ( PVAI ) on the outcome of paroxysmal , persistent , and permanent AF ablation . METHODS A total of 320 consecutive patients who had been referred to our center in order to undergo a first attempt of AF ablation were r and omized into 2 groups . Group I ( 160 patients ) underwent PVAI only ; Group II ( 160 patients ) underwent PVAI and SVCI . RESULTS AF was paroxysmal in 134 ( 46 % ) , persistent in 75 ( 23 % ) , and permanent in 111 ( 31 % ) of said patients . SVCI was performed on 134 of the 160 patients ( 84 % ) in Group II . SVC isolation was not performed on the remaining 26 patients either because of phrenic nerve capture or the lack of SVC potentials . Comparison of the outcome data between the 2 groups , after a follow-up of 12 months , revealed a significant difference in total procedural success solely with patients manifesting paroxysmal atrial fibrillation ( 56/73 [ 77 % ] Group I vs. 55/61 [ 90 % ] Group II ; P = 0.04 ; OR 2.78 ) . CONCLUSIONS In our study , the strategy of the empiric SVCI in addition to PVAI has improved the outcome of AF ablation solely in patients manifesting paroxysmal AF
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 .