Table 1. Comparison of pulsography integral area between atrial and ventricularpremature beat

advanced ratios(%)

Atrial premature beat Ventricular premature beat

n Pulsography integral area n pulsography integral area

>40 17 390.59�20.80 20 248.35�77.33

POST

ERABST

RACTS

ventricular cavity and often contain conduction tissue which proved in some case reports tocause ventricular tachycardia.Objectives: To investigate the electrocardiographic characteristics of patients with falsetendons.Methods: We studied 60 non cardiac patients with FTs and 60 non cardiac patients withERP. Patients were classified according to presence of ERP and FTs to: ERP+FT (group 1,n¼52 ) and ERP or FT (group 2, n¼68 ). ERP was defined as J point elevation manifestedeither as QRS slurring (transition from the QRS segment to the ST segment) or notching(positive deflection on terminal S wave), upper concavity ST segment elevation for morethan 0.1mV and prominent T waves in at least 2 contiguous leads. False tendons weredefined ( by 2D TTE) as bands stretching across the left ventricle (LV) from the ventricularseptum to the papillary muscle or LV free wall but not connecting, like the chordae ten-dinae, to the mitral leaflet. PRd, QRSd, QT, QTc, JT and JTc were calculated, site,morphology of ST elevation were identified and amplitude of ERP and number of leadswith ST elevation were calculated. Site and number of FTs were identified and length&thickness & volume of FT were measured. FTs were classified according to their points ofattachment as type 1 (longitudinal), type 2 (diagonal), type 3 (transverse) and type 4(weblike).Results: ERP was present in 29 patients (48.3%) of patients with FTs and FTs were presentin 23 patients (38.3%) of patients with false tendons .Horizontal ST segment elevation wasfound in (61.4%) patients of those with ER and FT which is much more common thanpatients with ER alone (27.8%) and this was statistically significant (P¼ 0.007). We foundthat 80% of patients with ER pattern in the inferior leads have oblique FTs (P ¼ 0.043).and 72% of patients with ER pattern in the infrolateral leads have transverse FTs (P ¼0.05).Conclusion: Our results suggest that FTs may play a role in genesis and determination ofsite and morphology of ERP.Disclosure of Interest: None Declared

PW019

Cardiac Arrhythmias During Pregnancy; managment

Pascal Lefebvre*1, Stéphanie Blondel21Cardiology, 2Obstetrics and gynaecology, CHU Charleroi, Charleroi, Belgium

Introduction: Pregnancy can precipitate cardiac arrhythmias not previously present inseemingly well individuals. Risk of arrhythmias is relatively higher during labor and de-livery. The exact mechanism of increased arrhythmia burden during pregnancy is unclear,but has been attributed to hemodynamic, hormonal, and autonomic changes related topregnancy.Objectives: Paroxysmal supraventricular and ventricular tachycardia may cause hemody-namic compromise with consequences to the fetus. Management of arrhythmias in preg-nant women is similar to that in non-pregnant but a special consideration must be given toavoid adverse fetal effects. However, due to the theoretical or known adverse effects ofantiarrhythmic drugs on the fetus, antiarrhythmic drugs are generally reserved for thetreatment of arrhythmias associated with significant symptoms or hemodynamiccompromise.Methods: Treatment strategies during pregnancy are hampered by the lack of randomizedtrials in this cohort of women. Choice of therapy, for the most part, is based on limited datafrom animal studies, case reports, observational studies, and clinical experience. Adenosineor a cardioselective beta-blocker could be used if vagal maneuvers are ineffective. Alter-natively, verapamil or diltiazem may be given. In pregnant women with atrial fibrillation,the goal of treatment is conversion to sinus rhythm or to control ventricular rate by acardioselective beta-adrenergic blocker drug or digoxin. Ventricular arrhythmias may occurin the pregnant women with cardiomyopathy, congenital heart disease, valvular heartdisease, or mitral valve prolapse. Termination of ventricular arrhythmias can usually beachieved by intravenous lidocaine or procainamide or by electrical cardioversion.Results: Direct current cardioversion to terminate maternal arrhythmias is well toleratedand effective, and should not be delayed if indicated. The use of an implantable car-dioverter-defibrillator should be considered for women of childbearing potential with life-threatening ventricular arrhythmias.Conclusion: During pregnancy, significant changes occur in the hormonal and hemody-namic state of women that make arrhythmias more likely to occur. Palpitations arefrequently reported, but are usually found to be associated with sinus tachycardia. Acutetreatment of arrhythmias for pregnant women is much the same as that for non-pregnantpatients. Chronic drug therapy during pregnancy should be reserved only for the frequent,hemodynamically significant arrhythmias.Disclosure of Interest: None Declared

PW020

Long-Term Arrhythmia-Free Survival In Patients With Severe Left VentricularDysfunction And No Inducible Ventricular Tachycardia Post Myocardial Infarction

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

Introduction: Patients with impaired left ventricular ejection fraction (LVEF) late aftermyocardial infarct (MI) derive a mortality benefit from prophylactic implantable-cardioverter defibrillator (ICD) therapy. As this mortality benefit was not seen early post-MI, guidelines limit ICDs to patients who are >40 days with LVEF�30%, or LVEF�35%in the presence of New York Heart Association (NYHA) class II/III heart failure (HF).However, LVEF alone as a risk stratification tool for prevention of sudden death is limitedby its poor specificity for arrhythmic versus non-arrhythmic cardiac death.

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

Objectives: We aimed to demonstrate that a negative electrophysiology study (EPS) can beused to delineate a sub-group of early post-MI patients with severely impaired LVEF whoare safe long-term without an ICD.Methods: Consecutive patients treated with primary percutaneous coronary interventionfor ST-elevation MI (STEMI) underwent early LVEF assessment. Patients with LVEF�40%underwent EPS. A prophylactic ICD was implanted for a positive [inducible monomorphicventricular tachycardia (VT)] but not for a negative (no inducible VT or inducible ven-tricular fibrillation (VF)/flutter) EPS result. Patients who would have become eligible for alate primary prevention ICD with LVEF�30% or �35% with NYHA class II/III heart failure(HF) were included and analysed according to EPS result. Patients with LVEF>40% whowere not eligible for EPS were followed as controls. The primary endpoint was survival freeof death or arrhythmia (resuscitated cardiac arrest or sustained VT/VF).Results: A total 1,722 STEMI patients underwent early (median 4 days) LVEF assessment.Patients with LVEF>40% made up 75% (n¼1,286). EPS was performed in 128 patientswith LVEF�30%/�35% & HF, with a negative EPS in 63% (n¼80) and a positive EPS in37% (n¼48). ICDs were implanted in <0.1%, 4% and 90% of control, EPS negative andEPS positive patients, respectively. At 3 years 93.4�1.0% of EPS negative patients withLVEF�30%/�35% & HF and 91.8�3.2% of control patients (LVEF>40%) were free ofdeath or arrhythmia (P¼0.953, Figure I), compared to 62.7�7.5% of EPS positive patientswith LVEF�30%/�35% & HF (P<0.001).Conclusion: Re-vascularised STEMI patients with severely impaired LV function but noinducible VT have favourable long term prognosis without the protection of an ICD.Disclosure of Interest: None Declared

PW021

The relationship between the coupling interval of premature beat and hemodynamics

Zhongjian Li*1, jihong Shen1, yuan Cheng1, shuaibing Li1, yan Jing11Electrocardiogrom Lab, The Second Affiliated Hospital of Zhengzhou University,Zhengzhou, China

Introduction: Premature beat is one of the most frequent cardiac arrhythmia in clinicalcardiovascular diseases. Many previous research of premature beat were about the causes,mechanism, whether accompanying with organic heart disease or not and whether willcause sudden death risk or not etc. Few studies have examined about hemodynamicchanges cased by shortening coupling interval of premature beat. Therefore, in order toexplore various kinds of premature coupling interval change impact on cardiac functionand hemodynamics, 70 cases of premature beat observed and analyzed.Objectives: To study the relationship between the coupling interval of premature beat(PB)and pulsography, and explore the effect of PB on the hemodynamics.Methods: 48 patients with artrial premature beat(APB,18 cases of premature beat originatefrom left atrial,30cases of premature beat originate from right atrial) and 51 patients withventricular premature beat(VPB,21 cases of premature beat originate from left ventricu-lar,30 cases of premature beat originate from right ventricular) were detected by 12 leadsurface electrocardiograms. They were divided according to the advanced ratios. Cardiacfunction was investigated through cardiac function check apparatus. The pulsographicareas were measured by signal processing technique.Results: 1. The pulsographic areas of PB were smallest when advanced ratios were>40%,which were middle when the ratios were between 20%>40%, and largest when theratios were <20% (P<0.05). 2. When advanced ratios were same, there was a negativecorrelation between left and right artrial of pulsographic areas (P<0.05); and a positivecorrelation between left and right ventricular (P<0.05).

Conclusion: The hemodynamics changes of were influenced by the coupling interval ofpremature beat and the original sites when they were ventricular premature beat.Disclosure of Interest: None Declared

PW022

Prognostic value of troponin I and NTproBNP concentration in patients afterin-hospital cardiac arrest

Filip M. Szymanski*1, Krzysztof J. Filipiak1, Anna E. Platek1, Anna Szymanska2,Grzegorz Karpinski1, Grzegorz Opolski11Cardiology Department, 2Department of Cardiology, Hypertension and Internal Diseases, TheMedical University of Warsaw, Warsaw, Poland

Introduction: Cardiovascular diseases are the leading cause of mortality and morbidityworldwide. Unfortunately, the cardiac arrest (CA) is often the first presentation of cardiacdisease in many patients.Objectives: The aim of the study was: /1/ to describe clinical characteristics of patients within-hospital cardiac arrest (IHCA), and /2/ to assess if troponin I and (NTproBNP) con-centration are predictive of mortality.Methods: We enrolled in the study 106 consecutive patients of intensive cardiac care unitexperiencing cardiac arrest within first 12 hours after admission. Baseline characteristics,

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