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(at least every two years) in cardiopulmonary resuscitation (CPR) and handling of theautomatic external defibrillator (AED). This program also includes the installation of AEDsin every subway station.Objectives: Calculate the rate of hospital survival in patients that suffered from cardiacarrest (CA) at Sao Paulo Subway after employees had received training and the imple-mentation of defibrillators at the subway stations had been done.Methods: We studied a prospective series of cases of sudden cardiac arrest in Sao Paulo’sSubways from September 2006 to November 2012. Subway security officials wereinstructed to perform CPR and to use AEDs. The outcome of each patient was followedthrough medical records of the hospitals to which patients were referred. Reading the DEAregistration of each patient was performed. The primary outcome was survival after 1 yearwithout neurologic impairment.Results: Automated external defibrillators were used in 62 patients whose initial cardiacrhythm was ventricular fibrillation. The average age of victims was 59.9� 14.1 years and 77%weremale. Thepercentage of patientswho achieved sustained returnof spontaneous circulationwas 74%; 54% patients arrived alive at the hospital, but only 35% were survived to dischargefrom the hospital without neurologic impairment. Comparing the periods Sept/2006 to Apr/2009 versus May/2009 to Nov/2012, respectively, the survival rate without neurologicimpairment was 22% vs. 50% after one month, and 20% vs. 43% after one year of the event.Conclusion: We conclude that the implementation of the program of public access todefibrillation greatly increased the survival rate of victims who suffered CA in Sao Paulo’sSubways. This is the highest rate of survival of CA registered in public place from LatinAmerica so far.Disclosure of Interest: None Declared

PT030

What Is The Optimal Left Ventricular Ejection Fraction Cut-Off For RiskStratification For Primary Prevention Of Sudden Cardiac Death Early AfterMyocardial Infarction?

Sarah Zaman*1, Arun Narayan1, Gopal Sivagangabalan1, Aravinda Thiagalingam1,Stuart Thomas1, David L. Ross1, Pramesh Kovoor11Cardiology, Westmead Hospital, sydney, Australia

Introduction: Optimal left ventricular ejection fraction (LVEF) to select patients early postmyocardial infarction (MI) for risk stratification for prevention of sudden cardiac death(SCD) in the era of primary percutaneous coronary intervention (PPCI) is unknown.Objectives: We aimed to determine the optimal LVEF dichotomy limit to select patientsearly after PPCI for ST-elevation MI (STEMI) to undergo further risk stratification with EPS,for primary prevention of SCD. The secondary aim was to determine the long term inci-dence of spontaneous tachyarrhythmia or death based on an early LVEF post-STEMI.Methods: Consecutive patients treated with PPCI for ST-elevation MI underwent earlyLVEF assessment. Electrophysiology study (EPS) was performed if LVEF�40% and aprophylactic implantable-cardioverter defibrillator (ICD) implanted for a positive [induc-ible monomorphic ventricular tachycardia (VT)], but not a negative, result. Patients werefollowed according to early LVEF with a primary endpoint of inducible VT at EPS and asecondary combined endpoint of death or arrhythmia (SCD, resuscitated cardiac arrest orECG-documented VT/ventricular fibrillation).Results: A total of 1,722 STEMI patients underwent early (median 4 days) LVEF assessment.The proportion of patients with early LVEF>40%, 36-40%, 31-35% and �30% was 75%(n¼1,286), 7% (n¼128), 8% (n¼136) and 10% (n¼172), respectively. Inducible VToccurred in 22%, 25% and 40% of patients with LVEF 36-40%, 31-35% and �30%,respectively (p¼0.014). At 3 years death or arrhythmia occurred in 6.6�0.8%, 8.1�2.6%,18.0�3.4% and 37.4�3.9% of patients with LVEF>40%, 36-40%, 31-35% and �30%,respectively (overall P<0.001; LVEF 36-40% versus LVEF>40% P¼0.265, Figure I). In EPS-positive patients with LVEF 36-40%, 31-35% and �30%, the number of patients receivingan ICD to treat one arrhythmic event was 18.3�1.2, 11.5�1.5 and 4.2�3.0, respectively.

GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters

Conclusion: A cut-off LVEF�40% selects patients with a high incidence of inducible VTpost-PPCI. Patients with LVEF�35% and inducible VT appear to derive a greater benefitfrom prophylactic ICD implantation due to their higher risk of death or arrhythmia.Disclosure of Interest: None Declared

PT031

Assessment of autonomic function after long term follow-up in young adults withvasovagal syncope, who underwent Senning atrial switch correction of d-transposition of great arteries

Beata Pietrucha*1, Artur Z. Pietrucha2, Irena B. Bzukala2, Danuta Mroczek-Czernecka2,Ewa Konduracka2, Wieslawa Piwowarska3, Andrzej Rudzinski1, Jadwiga Nessler21Department of Children Cardiology, Children University Hospital, Medical College ofJagiellonian University, 2Department of Coronary Disease, Medical College of JagiellonianUniversity, John Paul II Hospital, 3Department of Coronary Disease, Medical College ofJagiellonian University, Cracow, Poland

Introduction:We try to evaluate a baroreceptors sensitivity (BRS) in relation to presence ofreflex syncope in young adults with benign forms of sinus node dysfunction (SND) in near-asymptomatic young adults after reparation of d-transposition of great arteries d-TGA bySenning atrial switch (SAS)Objectives: We observed 21 pts (14 men) aged 18-21 yrs with d-TGA, with ECG-signs ofSND and history of presyncope and 21 sex and age matched healthy volunteers.Methods: All pts underwent head-up tilt test (HUTT) and transoesophageal atrial stimu-lation for evaluation of corrected sinus node recovery times (CNRT) before and afterpharmacological blockade (PHB). CNRT>525 ms was assumed as abnormal. Non-invasiveevaluation of BRS during HUTT was evaluated in dTGA patients and healthy control groupusing NEXFIN analyser.Results: HUTT was positive in 6 pts (28,6%). Mean CNRT value was 698,2ms, and shortensignificantely after PHB (362,8ms). Reduction of BRSwas observed in dTGApts. in comparisonto healthy controls. Depletion of BRS was observed in pts. with negative HUTT in relation tonon-fainter, both in dTGA(SBP: 11,4 vs16,9ms/mmHg;DBP18,4 vs 21,1mmHg;p<0,03) andcontrol groups (SBP: 12,6 vs 19,4 ms/mmHg; DBP 13,3 vs 16,6 mmHg;p<0,02).Conclusion:

1. Reflex vasovagal syncope frequently occurs after physiological correction of d-TGA.2. Reduction of baroreceptor sensitivity was observed after dTGA correction by atrial

switch both in pts. with positive and negative HUTT.3. Electrocardiographic signs of sinus node dysfunction rather then abnormal elec-

trophysiological parameters were noticed in near-asymptomatic young adults afterreparation of d-TGA by Senning atrial switch

Disclosure of Interest: None Declared

PT032

Epicardial fat may have a role in predicting VT

Sujitha Thavapalachandran*1, Jim Pouliopoulos1,2, Dushan Bandara1, Neeru Agarwal1,Angela McPhee1, Pramesh Kovoor1,2, Aravinda Thiagalingam1,2

1Cardiology, Westmead Hospital, 2Sydney University, Sydney, Australia

Introduction: Intramyocardial adiposity of left ventricular scar borders post infarction is asignificant factor for increased propensity of ventricular tachycardia (VT) post myocardialinfarction. Previous studies have shown a significant correlation between echocardio-graphic epicardial fat and intramyocardial fat content. Epicardial fat using TTE is an easy,reliable and non-invasive imaging method for assessing epicardial fat.Objectives: To determine whether there is a correlation between epicardial fat thicknessand VT inducibility using TTE.Methods: Epicardial fat thickness was measured in 50 patients (22 women, 28 men, meanage 62.5 +/- 14.2 years, median BSA 1.92m2) who underwent a TTE and electrophysiologystudy (EPS) for clinical indications within a 6 month period.Results: Among 50 patients, 40% had VT inducibility on EPS. These subjects showedmedian values of epicardial fat thickness of 3.0 +/- 0.9 mm, significantly lower than those insubjects without VT inducibility (epicardial fat thickness 4.3+/- 1.1 mm). Non-parametrictesting using the Mann-Whitney test showed a statistical significance between these twogroups (P<0.05). With further adjustment of other factors such as BSA, post-myocardialinfarction and LV dysfunction, VT inducibility was still associated with a lower epicardialfat than the non-VT inducibility group.Conclusion: Epicardial fat thickness was significantly lower in patients with inducible VTin this pilot study; however, the significance of this correlation is uncertain. Further in-vestigations are required to confirm or refute a physiologic mechanism or explanation forthis relationship.Disclosure of Interest: None Declared

PT036

Gender differences in acute decompensated heart failure patients: Insights from theHeart function Assessment Registry Trial in Saudi Arabia (HEARTS)

Hussam AlFaleh*1, khalid AlHabib1, Abdelfatah Elasfar2, Tarek Kashour1, Ahmed Hersi1,Hanan AlBackr1, Fayez Alshaer1, Gamal Hussein3, Layth Mimish4, Ali Almasood5,Waleed AlHabib1, Saleh AlGhamdi6, Abdullah Ghabashi7, Asif Malik8, Ahmed Abuosa91Cardiac Sciences, King Saud University, King Khalid university Hospital, 2CardiologyDepartment, Prince Salman Heart Center, King Fahd Medical City, Riyadh, 3Cardiology

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