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  • Pekka Raatikainen, M. J.Central Finland Health Care Dist, Finland; University of Eastern Finland, Finland,Kuopio University Hospital, Finland (author)

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

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • ELSEVIER IRELAND LTD,2015
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-121421
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-121421URI
  • https://doi.org/10.1016/j.ijcard.2015.06.160DOI
  • https://lup.lub.lu.se/record/7749826URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Danish Heart Foundation [05-4-B284-A466-22237]; Finnish Foundation for Cardiovascular Research; Biosense Webster
  • 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.

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  • Hakalahti, AnttiUniversity of Oulu, Finland (author)
  • Uusimaa, PaavoUniversity of Oulu, Finland (author)
  • Cosedis Nielsen, JensAarhus University Hospital, Denmark (author)
  • Johannessen, ArneGentofte University Hospital, Denmark (author)
  • Hindricks, GerhardLeipzig University Hospital, Germany (author)
  • Walfridsson, HåkanLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)hakwa83 (author)
  • Pehrson, SteenRigshosp, Denmark (author)
  • Englund, AndersUniversity Hospital, Sweden (author)
  • Hartikainen, JuhaKuopio University Hospital, Finland (author)
  • Kongstad Rasmussen, OleLund 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(Swepub:lu)kard-oko (author)
  • Spange Mortensen, LeifUNI C, Denmark (author)
  • Steen Hansen, PeterAarhus University Hospital, Denmark (author)
  • Central Finland Health Care Dist, Finland; University of Eastern Finland, FinlandKuopio University Hospital, Finland (creator_code:org_t)

Related titles

  • In:International Journal of Cardiology: ELSEVIER IRELAND LTD198, s. 108-1140167-52731874-1754

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