{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:34:52Z","timestamp":1790710492140,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/100007497","name":"Biosense Webster","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007405","name":"Hjerteforeningen","doi-asserted-by":"publisher","award":["05-4-B284-A466-22237"],"award-info":[{"award-number":["05-4-B284-A466-22237"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2016,8,5]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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&lt;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, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      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&lt;0.001), and did not differ from 2-year scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT00133211; Results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-309781","type":"journal-article","created":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T22:39:15Z","timestamp":1472251155000},"page":"368-376","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial"],"prefix":"10.1136","volume":"103","clinical-trial-number":[{"clinical-trial-number":"nct00911508","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct01288352","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jens Cosedis","family":"Nielsen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Johannessen","sequence":"additional","affiliation":[{"name":"Gentofte University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"Raatikainen","sequence":"additional","affiliation":[{"name":"Heart Center Co. Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Hindricks","sequence":"additional","affiliation":[{"name":"Leipzig University Hospital, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Walfridsson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Medical and Health Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen Michael","family":"Pehrson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Hospital, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif Spange","family":"Mortensen","sequence":"additional","affiliation":[{"name":"UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Steen","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,8,26]]},"reference":[{"key":"2025092013324324000_103.5.368.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"2025092013324324000_103.5.368.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1113566"},{"key":"2025092013324324000_103.5.368.3","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu376"},{"key":"2025092013324324000_103.5.368.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.467"},{"key":"2025092013324324000_103.5.368.5","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup122"},{"key":"2025092013324324000_103.5.368.6","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu342"},{"key":"2025092013324324000_103.5.368.7","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-10-44"},{"key":"2025092013324324000_103.5.368.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.02.018"},{"key":"2025092013324324000_103.5.368.9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.946806"},{"key":"2025092013324324000_103.5.368.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.02.003"},{"key":"2025092013324324000_103.5.368.11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000471"},{"key":"2025092013324324000_103.5.368.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.302226"},{"key":"2025092013324324000_103.5.368.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.12.016"},{"key":"2025092013324324000_103.5.368.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408288"},{"key":"2025092013324324000_103.5.368.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.072"},{"key":"2025092013324324000_103.5.368.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.957761"},{"key":"2025092013324324000_103.5.368.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2012.07.016"},{"key":"2025092013324324000_103.5.368.18","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12264"},{"key":"2025092013324324000_103.5.368.19","doi-asserted-by":"publisher","DOI":"10.1253\/circj.68.568"},{"key":"2025092013324324000_103.5.368.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.09.053"},{"key":"2025092013324324000_103.5.368.21","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu028"},{"key":"2025092013324324000_103.5.368.22","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu359"},{"key":"2025092013324324000_103.5.368.23","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu307"},{"key":"2025092013324324000_103.5.368.24","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu421"},{"key":"2025092013324324000_103.5.368.25","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003862"},{"key":"2025092013324324000_103.5.368.26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.468"},{"key":"2025092013324324000_103.5.368.27","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.824789"},{"key":"2025092013324324000_103.5.368.28","first-page":"170","article-title":"Radiofrequency ablation versus antiarrhythmic drug therapy for atrial fibrillation. 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