# Katheterablatie als eerstelijnsbehandeling bij paroxysmaal AF: 5-jaarsresultaten

*geplaatst 2017-03-01 · Atriumfibrilleren · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2016-309781 · https://hartvaat.nl/2017/03/01/katheterablatie-als-eerstelijnsbehandeling-bij-paroxysmaal-af-5-jaarsresultaten/*

5-jaarsfollow-up van een gerandomiseerde trial die katheterablatie als eerste behandeling vergeleek met antiaritmica bij paroxysmaal AF. Langetermijnbewijs voor vroege ablatiestrategie.

## English: Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial.

This 5-year follow-up of a randomized trial showed that catheter ablation as first-line therapy for paroxysmal AF maintained superior rhythm control compared with antiarrhythmic drugs over the long term, providing early evidence for the ablation-first approach.

## Abstract (original, from the publication)

OBJECTIVE: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial compared radiofrequency catheter ablation (RFA) with antiarrhythmic drug therapy (AAD) as first-line treatment for paroxysmal atrial fibrillation (AF). Endpoint of ablation was elimination of electrical activity inside pulmonary veins. We present the results of the 5-year follow-up. METHODS: This pre-specified 5-year follow-up included assessment of any AF and symptomatic AF burden by one 7-day Holter recording and quality of life (QoL) assessment, using SF-36 questionnaire physical and mental component scores. Analysis was intention-to-treat. Imputation was used to compensate for missing Holter data. RESULTS: 245 of 294 patients (83%) randomised to RFA (n=125) or AAD (n=120) attended the 5-year follow-up, 227 with Holter recording. Use of class I or III AAD was more frequent in AAD group (N=61 vs 13, p<0.001). More patients in the RFA group were free from AF (126/146 (86%) vs 105/148 (71%), p=0.001, relative risk (RR) 0.82; 95% CI 0.73 to 0.93) and symptomatic AF (137/146 (94%) vs 126/148 (85%), p=0.015, χ2 test, RR 0.91; 95% CI 0.84 to 0.98) in 7-day Holter recording. AF burden was significantly lower in the RFA group (any AF: p=0.003; symptomatic AF: p=0.02). QoL scores did not differ between randomisation groups. QoL scores remained improved from baseline (both components p<0.001), and did not differ from 2-year scores. CONCLUSIONS: At 5 years, the occurrence and burden of any AF and symptomatic AF were significantly lower in the RFA group than in the AAD group. Improved QoL scores observed after 2 years persisted after 5 years without between-group differences. TRIAL REGISTRATION NUMBER: NCT00133211; Results.

Auteurs: Jens Cosedis Nielsen, Arne Johannessen, Pekka Raatikainen, Gerhard Hindricks, Håkan Walfridsson, Steen Michael Pehrson, Anders Englund, Juha Hartikainen, Leif Spange Mortensen, Peter Steen Hansen

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2016-309781. Bijgewerkt 2026-07-03T13:25:53Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.