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 .
Catheter ablation for paroxysmal atrial fibrillation: a randomized comparison between multielectrode catheter and point-by-point ablation.
INTRODUCTION Catheter ablation for paroxysmal atrial fibrillation is widely used for patients with drug-refractory paroxysms of arrhythmia . Recently , novel technologies have been introduced to the market that aim to simplify and shorten the procedure . AIM To compare the clinical outcome of pulmonary vein ( PV ) isolation using a multipolar circular ablation catheter ( PVAC group ) , with point-by-point PV isolation using an irrigated-tip ablation catheter and the CARTO mapping system ( CARTO group ; CARTO , Biosense Webster , Diamond Bar , CA , USA ) . METHODS Patients with documented PAF were r and omized to undergo PV isolation using PVAC or CARTO .  Atrial fibrillation ( AF ) recurrences were documented by serial 7-day Holter monitoring . RESULTS One hundred and two patients ( mean age 58 ± 11 years , 68 men ) were included in the study . The patients had comparable baseline clinical characteristics , including left atrial dimensions and left ventricular ejection fraction , in both study arms ( PVAC : n = 51 and CARTO : n = 51 ) . Total procedural and fluoroscopic times were significantly shorter in the PVAC group ( 107 ± 31 minutes vs 208 ± 46 minutes , P < 0.0001 and 16 ± 5 minutes vs 28 ± 8 minutes , P < 0.0001 , respectively ) . The AF recurrence was documented in 23 % and 29 % of patients in the PVAC and CARTO groups , respectively ( P = 0.8 ) , during the mean follow-up of 200 ± 13 days . No serious complications were noted in both study groups . CONCLUSIONS Clinical success rates of PV isolation are similar when using multipolar circular PV ablation catheter and point-by-point ablation with a three-dimensional ( 3D ) navigation system in patients with PAF , and results in shorter procedural and fluoroscopic times with a comparable safety profile
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 .