Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial
2015 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 17, no 2, 215-221 p.Article in journal (Refereed) Published
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.
Atrial fibrillation; Catheter ablation; Antiarrhythmic drug treatment; First-line therapy; Quality of life
IdentifiersURN: urn:nbn:se:liu:diva-117391DOI: 10.1093/europace/euu342ISI: 000351601600009PubMedID: 25567068OAI: oai:DiVA.org:liu-117391DiVA: diva2:807774
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)2015-04-242015-04-242016-04-11