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
| Autor: | Arne Johannessen, Anders Englund, Gerhard Hindricks, Leif Spange Mortensen, Antti Hakalahti, Håkan Walfridsson, Peter Steen Hansen, Steen Pehrson, Juha Hartikainen, Jens Cosedis Nielsen, M.J. Pekka Raatikainen, Ole Kongstad, Paavo Uusimaa |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Radiofrequency ablation Paroxysmal atrial fibrillation medicine.medical_treatment Catheter ablation law.invention Therapy naive Randomized controlled trial law Internal medicine Atrial Fibrillation medicine Humans In patient Prospective Studies Aged Cross-Over Studies business.industry Atrial fibrillation Middle Aged medicine.disease Treatment Outcome Radiofrequency catheter ablation Anesthesia Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Follow-Up Studies |
| Zdroj: | Raatikainen, M J P, Hakalahti, A, Uusimaa, P, Nielsen, J C, Johannessen, A, Hindricks, G, Walfridsson, H, Pehrson, S, Englund, A, Hartikainen, J, Kongstad, O, Mortensen, L S, Hansen, P S & MANTRA-PAF Investigators 2015, ' 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 ', International Journal of Cardiology, vol. 198, pp. 108-114 . https://doi.org/10.1016/j.ijcard.2015.06.160 |
| DOI: | 10.1016/j.ijcard.2015.06.160 |
| Popis: | 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 24months and cumulative AF burden in all recordings. At 24months, 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% (PCONCLUSIONS: In the treatment of antiarrhythmic therapy naïve 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). |
| Databáze: | OpenAIRE |
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