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Radiofrequency cath...
Radiofrequency catheter ablation maintains its efficacy better than antiarrhythmic medication in patients with paroxysmal atrial fibrillation: On-treatment analysis of the randomized controlled MANTRA-PAF trial
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- Pekka Raatikainen, M. J. (author)
- Central Finland Health Care Dist, Finland; University of Eastern Finland, Finland,Kuopio University Hospital, Finland
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- Hakalahti, Antti (author)
- University of Oulu, Finland
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- Uusimaa, Paavo (author)
- University of Oulu, Finland
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- Cosedis Nielsen, Jens (author)
- Aarhus University Hospital, Denmark
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- Johannessen, Arne (author)
- Gentofte University Hospital, Denmark
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- Hindricks, Gerhard (author)
- Leipzig University Hospital, Germany
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- Walfridsson, Håkan (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Pehrson, Steen (author)
- Rigshosp, Denmark
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- Englund, Anders (author)
- University Hospital, Sweden
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- Hartikainen, Juha (author)
- Kuopio University Hospital, Finland
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- Kongstad Rasmussen, Ole (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,University of Lund Hospital, Sweden
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- Spange Mortensen, Leif (author)
- UNI C, Denmark
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- Steen Hansen, Peter (author)
- Aarhus University Hospital, Denmark
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(creator_code:org_t)
- ELSEVIER IRELAND LTD, 2015
- 2015
- English.
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In: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 198, s. 108-114
- Related links:
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
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- Background: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) is a randomized trial comparing radiofrequency catheter ablation (RFA) to antiarrhythmic drugs (AADs) as first-line treatment of paroxysmal atrial fibrillation (PAF). In order to eliminate the clouding effect of crossover we performed an on-treatment analysis of the data. Methods and results: Patients (n = 294) were divided into three groups: those receiving only the assigned therapy (RFA and AAD groups) and those receiving both therapies (crossover group). The primary end points were AF burden in 7-day Holter recordings at 3, 6, 12, 18, and 24 months and cumulative AF burden in all recordings. At 24 months, AF burden was significantly lower in the RFA (n = 110) than in the AAD (n = 92) and the crossover (n = 84) groups (90th percentile 1% vs. 10% vs. 16%, P = 0.007), and more patients were free from any AF (89% vs. 73% vs. 74%, P = 0.006). In the RFA, AAD and the crossover groups 63%, 59% and 21% (P less than 0.001) of the patients had no AF episodes in any Holter recording, respectively. Quality of life improved significantly in all groups. There were no differences in serious adverse events between the RFA, AAD and crossover groups (19% vs. 8% vs. 23%) (P = 0.10). Conclusions: In the treatment of antiarrhythmic therapy naive patients with PAF long-term efficacy of RFA was superior to AAD therapy. Thus, it is reasonable to offer RFA as first-line treatment for highly symptomatic patients who accept the risks of the procedure and are aware of frequent need for reablation(s). (C) 2015 Elsevier Ireland Ltd. All rights reserved.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Atrial fibrillation; Catheter ablation; Antiarrhythmic drug; On-treatment analysis; Long-term efficacy
Publication and Content Type
- ref (subject category)
- art (subject category)
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Pekka Raatikaine ...
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Hakalahti, Antti
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Uusimaa, Paavo
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Cosedis Nielsen, ...
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Johannessen, Arn ...
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Hindricks, Gerha ...
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Walfridsson, Håk ...
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Pehrson, Steen
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Englund, Anders
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Hartikainen, Juh ...
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Kongstad Rasmuss ...
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Spange Mortensen ...
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Steen Hansen, Pe ...
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Linköping University
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Lund University