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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EAt 5 years, patients in the MANTRA-PAF trial treated with radiofrequency ablation had less atrial fibrillation burden and episodes of symptomatic atrial fibrillation compared with antiarrhythmic drug. However, there was no significant difference in quality of life measures.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EMANTRA-PAF\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eatrial fibrillation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eantiarrhythmic drug\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eradiofrequency ablation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecatheter ablation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional techniques \u0026amp; devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Earrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology \u0026amp; cardiovascular medicine clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EFirst-line treatment of symptomatic paroxysmal atrial fibrillation (AF) with radiofrequency ablation (RFA) resulted in reduced occurrence and burden of AF at 5 years compared with antiarrhythmic drug (AAD) therapy. Jens Cosedis Nielsen, MD, PhD, Aarhus University, Aarhus, Denmark, presented 5-year follow-up data from the MANTRA-PAF [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00133211\u0026amp;atom=%2Fspmdc%2F15%2F28_suppl_2%2F8.atom\u0022\u003ENCT00133211\u003C\/a\u003E].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EOver a 2-year period, there was no significant difference in AF, and improvements in quality of life were similar in patients with paroxysmal AF who received either RFA or AAD therapy [Nielsen JC et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E. 2012]. The purpose of this analysis of the MANTRA-PAF trial was to evaluate the 5-year outcomes among patients who received first-line treatment with either RFA or AAD.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the multicenter MANTRA-PAF trial, 294 patients with symptomatic paroxysmal AF were randomly assigned to undergo RFA or receive AAD. A 5-year follow-up was preplanned and included a 7-day Holter monitoring, quality of life assessment, AAD use, and RFA since 2-year follow-up. The mean age at baseline was 55 years, and 32% of patients had hypertension, 5% had diabetes mellitus, and 3% had a prior stroke or transient ischemic attack. The CHADS\u003Csub\u003E2\u003C\/sub\u003E score was 0 in 144 patients, 1 in 75 patients, and \u2265\u20052 in 26 patients.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAt 5 years, the burden of AF was significantly lower in patients who underwent RFA compared with patients who received AAD (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.003). In addition, treatment of AF with RFA resulted in a greater proportion of patients achieving freedom from any AF, freedom from symptomatic AF, and lower rates of persistent AF (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Overall, the burden of AF was lower with both therapies compared with baseline. However, there was no significant difference in the physical or mental components of quality of life at 5 years.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/17036\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/17036\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/17036\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EAF by 7-Day Holter Monitoring at 5 Years of Follow-up\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EPatients in the AAD arm were significantly more likely to be taking a class Ic AAD at 5 years compared with the RFA arm (\u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.001). In addition, slightly more patients in the AAD arm were taking a calcium-channel blocker or digoxin at 5 years compared with patients who underwent RFA. The proportion of patients taking a class III agent was similar among both arms.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EProf Nielsen concluded that the data from this 5-year follow-up of the MANTRA-PAF trial suggest that first-line treatment of AF with RFA led to improved outcomes with decreased occurrence and burden of symptomatic AF compared with patients who received AAD therapy. However, he acknowledged that there are currently no data that indicate RFA improves survival compared with AAD therapy, and the risk of severe complications associated with RFA must be considered when advising patients.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/28_suppl_2\/8.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl7kq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzl7kq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}