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 .
Comparison of surgical cut and sew versus radiofrequency pulmonary veins isolation for chronic permanent atrial fibrillation: a randomized study.
BACKGROUND Surgical pulmonary veins isolation ( PVI ) is done to restore sinus rhythm ( SR ) in patients with chronic permanent atrial fibrillation ( CPAF ) and mitral valve disease . Here we compare the efficacy of electrical block lines performed with radiofrequency ( RF ) compared with conventional surgery . METHODS R and omized trial of 22 patients with CPAF and indication for mitral valve surgery . Ten patients underwent conventional surgery ( SURG )  and 12 RF .  To prove the efficacy of the blockage lines , epicardial pacemaker wires were placed in the isolated pulmonary veins region ( IPVR ) and right atria ( RA ) . RESULTS There were no differences in the baseline data among the groups . All patients remained in SR during the immediate postoperative period . Block lines were tested in patients who remained in SR during the following days ( eight in SURG and nine in RF ) . The median value of thresholds to conduct the stimulus of IPVR for the RA was 18 mA in SURG and 3 mA in RF ( P < 0.022 ) . Eight SURG patients and seven RF patients ( P < 0.38 ) remained in SR at hospital discharge . Eleven RF patients and one SURG required amiodarone to maintain SR ( P < 0.001 ) . The incidence of recurrent atrial fibrillation ( AF ) in the follow-up was 10.7/100 patients /year in the SURG group versus 73.1/100 patients /year in the RF group ( P = 0.009 ) . CONCLUSIONS PVI by SURG formed more effective block lines than RF . SR at hospital discharge was similar among the groups , but more amiodarone was used in RF . During follow-up , incidence of recurrent AF was higher in the RF group
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 .