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 .
The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy.
OBJECTIVES We sought to assess the impact of  intermittent atrial fibrillation ( AF ) on health-related quality of life ( QoL ) . BACKGROUND Intermittent AF is a common condition with little data on health-related QoL question naires to guide investigational therapies . METHODS Out patients from four centers , with documented AF ( n = 152 ) , completed vali date d QoL question naires ( Medical Outcomes Study Short Form 36 [ SF-36 ] , Specific Activity , Symptom Checklist , Illness Intrusiveness and University of Toronto AF Severity Scales ) . Comparison groups were made up of healthy individuals ( n = 47 ) and four cardiac control groups : published ( n = 78 ) and created for study ( n = 69 ) percutaneous transluminal coronary angioplasty ( PTCA ) ; published heart failure ( n = 216 ) and published postmyocardial infa rct ion ( MI ) ( n = 107 ) . RESULTS Across all domains of the SF-36 , AF patients reported substantially worse QoL than healthy controls ( 1.3 to 2.0 st and ard deviation units ) , with scores of 24 % , 23 % , 16 % and 30 % lower than healthy individuals on measures of physical and social functioning , mental and general health , respectively ( all p < 0.001 ) . Patients with AF were either significantly worse ( p < 0.05 , published controls ) or as impaired ( study controls ) as either PTCA or post-MI patients on all domains of the SF-36 and the same as heart failure controls on SF-36 psychological subscales . Patients with AF were as impaired or worse than study PTCA controls on measures of illness intrusiveness , activity limitations and symptoms . Associations between objective disease indexes and subjective QoL measures had poor correlations and accounted for < 6 % of the total variability in QoL scores . CONCLUSIONS Quality of life is as impaired in patients with intermittent AF as in patients with significant structural heart disease . Patients ' perception of QoL is not dependent on the objective measures of disease severity that are usually employed
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 .