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  • Nielsen, Jens CosedisAarhus Univ Hosp, Aarhus, Denmark,Aarhus University Hospital, Denmark (author)

Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation : 5-year outcome in a randomised clinical trial.

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • 2016-08-26
  • BMJ Publishing Group Ltd,2017
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-57434
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-57434URI
  • https://doi.org/10.1136/heartjnl-2016-309781DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-133317URI

Supplementary language notes

  • Language:English
  • Summary in:English

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

Notes

  • Funding agenciesDanish Heart Foundation, grant no:  05-4-B284-A466-22237 Biosense Webster
  • Funding agencies: Danish Heart Foundation [05-4-B284-A466-22237]; Biosense Webster
  • 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.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Johannessen, ArneGentofte University Hospital, Copenhagen, Denmark (author)
  • Raatikainen, PekkaHeart Center Co. Tampere University Hospital, Tampere, Finland (author)
  • Hindricks, GerhardLeipzig University Hospital, Leipzig, Germany (author)
  • Walfridsson, HåkanLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)hakwa83 (author)
  • Pehrson, Steen MichaelDepartment of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark (author)
  • Englund, AndersRegion Örebro län,Department of Medicine, Örebro University Hospital, Örebro, Sweden (author)
  • Hartikainen, JuhaKuopio University Hospital, Kuopio, Finland (author)
  • Mortensen, Leif SpangeUNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark (author)
  • Mantra-Paf Investigators, Group Author (author)
  • Steen Hansen, PeterMANTRA-PAF Investigators. UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark (author)
  • Aarhus Univ Hosp, Aarhus, DenmarkAarhus University Hospital, Denmark (creator_code:org_t)

Related titles

  • In:Heart: BMJ Publishing Group Ltd103:5, s. 368-3761355-60371468-201X

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