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Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0003-3059-4404
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
Aarhus University Hospital, Denmark.
Gentofte University Hospital, Denmark.
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2015 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 17, no 2, 215-221 p.Article in journal (Refereed) Published
Abstract [en]

Aims The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF. In this substudy, we evaluated the effect of these treatment modalities on the Health-Related Quality of Life (HRQoL) and symptom burden of patients at 12 and 24 months. Methods and results During the study period, 294 patients were enrolled in the MANTRA-PAF trial and randomized to receive AAD (N = 148) or RFA (N = 146). Two generic questionnaires were used to assess the HRQoL [Short Form-36 (SF-36) and EuroQol-five dimensions (EQ-5D)], and the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) was used to evaluate the symptoms appearing during the trial. All comparisons were made on an intention-to-treat basis. Both randomization groups showed significant improvements in assessments with both SF-36 and EQ-5D, at 24 months. Patients randomized to RFA showed significantly greater improvement in four physically related scales of the SF-36. The three most frequently reported symptoms were breathlessness during activity, pronounced tiredness, and worry/anxiety. In both groups, there was a significant reduction in ASTA symptom index and in the severity of seven of the eight symptoms over time. Conclusion Both AAD and RFA as first-line treatment resulted in substantial improvement of HRQoL and symptom burden in patients with PAF. Patients randomized to RFA showed greater improvement in physical scales (SF-36) and the EQ-visual analogue scale.

Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy B - Oxford Open Option B - CC-BY , 2015. Vol. 17, no 2, 215-221 p.
Keyword [en]
Atrial fibrillation; Catheter ablation; Antiarrhythmic drug treatment; First-line therapy; Quality of life
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-117391DOI: 10.1093/europace/euu342ISI: 000351601600009PubMedID: 25567068OAI: oai:DiVA.org:liu-117391DiVA: diva2:807774
Note

Funding Agencies|Danish Heart Foundation (Copenhagen, Denmark) [05-4-B284-A46622237]; Carldavid Jonsson Research Foundation; ALF-grants; County Council of Ostergotland; Finnish Foundation for Cardiovascular Research; Biosense-Webster (Diegem, Belgium)

Available from: 2015-04-24 Created: 2015-04-24 Last updated: 2016-04-11

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Walfridsson, HåkanWalfridsson, UllaJanzon, MagnusLevin, Lars-ÅkeAronsson, Mattias
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in LinköpingDivision of Nursing ScienceDivision of Health Care AnalysisFaculty of Health Sciences
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