liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
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
Central Finland Health Care Dist, Finland; University of Eastern Finland, Finland.
University of Oulu, Finland.
University of Oulu, Finland.
Aarhus University Hospital, Denmark.
Show others and affiliations
2015 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 198, 108-114 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2015. Vol. 198, 108-114 p.
Keyword [en]
Atrial fibrillation; Catheter ablation; Antiarrhythmic drug; On-treatment analysis; Long-term efficacy
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-121421DOI: 10.1016/j.ijcard.2015.06.160ISI: 000360319900036PubMedID: 26163901OAI: oai:DiVA.org:liu-121421DiVA: diva2:855146
Note

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

Available from: 2015-09-18 Created: 2015-09-18 Last updated: 2016-04-14

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Walfridsson, Håkan
By organisation
Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
In the same journal
International Journal of Cardiology
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 50 hits
ReferencesLink to record
Permanent link

Direct link