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Long-term efficacy ...
Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation : 5-year outcome in a randomised clinical trial.
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- Nielsen, Jens Cosedis (author)
- Aarhus Univ Hosp, Aarhus, Denmark,Aarhus University Hospital, Denmark
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- Johannessen, Arne (author)
- Gentofte University Hospital, Copenhagen, Denmark
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- Raatikainen, Pekka (author)
- Heart Center Co. Tampere University Hospital, Tampere, Finland
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- Hindricks, Gerhard (author)
- Leipzig University Hospital, Leipzig, 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 Michael (author)
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
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- Englund, Anders (author)
- Region Örebro län,Department of Medicine, Örebro University Hospital, Örebro, Sweden
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- Hartikainen, Juha (author)
- Kuopio University Hospital, Kuopio, Finland
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- Mortensen, Leif Spange (author)
- UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark
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Mantra-Paf Investigators, Group Author (author)
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- Steen Hansen, Peter (author)
- MANTRA-PAF Investigators. UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark
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(creator_code:org_t)
- 2016-08-26
- 2017
- English.
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In: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 103:5, s. 368-376
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- OBJECTIVE: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial compared radiofrequency catheter ablation (RFA) with antiarrhythmic drug therapy (AAD) as first-line treatment for paroxysmal atrial fibrillation (AF). Endpoint of ablation was elimination of electrical activity inside pulmonary veins. We present the results of the 5-year follow-up.METHODS: This pre-specified 5-year follow-up included assessment of any AF and symptomatic AF burden by one 7-day Holter recording and quality of life (QoL) assessment, using SF-36 questionnaire physical and mental component scores. Analysis was intention-to-treat. Imputation was used to compensate for missing Holter data.RESULTS: 245 of 294 patients (83%) randomised to RFA (n=125) or AAD (n=120) attended the 5-year follow-up, 227 with Holter recording. Use of class I or III AAD was more frequent in AAD group (N=61 vs 13, p<0.001). More patients in the RFA group were free from AF (126/146 (86%) vs 105/148 (71%), p=0.001, relative risk (RR) 0.82; 95% CI 0.73 to 0.93) and symptomatic AF (137/146 (94%) vs 126/148 (85%), p=0.015, χ(2) test, RR 0.91; 95% CI 0.84 to 0.98) in 7-day Holter recording. AF burden was significantly lower in the RFA group (any AF: p=0.003; symptomatic AF: p=0.02). QoL scores did not differ between randomisation groups. QoL scores remained improved from baseline (both components p<0.001), and did not differ from 2-year scores.CONCLUSIONS: At 5 years, the occurrence and burden of any AF and symptomatic AF were significantly lower in the RFA group than in the AAD group. Improved QoL scores observed after 2 years persisted after 5 years without between-group differences.TRIAL REGISTRATION NUMBER: NCT00133211; Results.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Catheter ablation
- Cardiology
- Kardiologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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Heart
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Nielsen, Jens Co ...
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Johannessen, Arn ...
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Raatikainen, Pek ...
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Hindricks, Gerha ...
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Walfridsson, Håk ...
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Pehrson, Steen M ...
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Englund, Anders
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Hartikainen, Juh ...
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Mortensen, Leif ...
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Mantra-Paf Inves ...
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- MEDICAL AND HEALTH SCIENCES
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Heart
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Örebro University
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Linköping University