Jun 18, 2018 - We calculated QTc, JT, JTc, JT, and QT dispersion. Results: Results: are shown in the table. Repolarization parameters (QT dispersion.
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P1562 Impact of multipoint pacing in ventricular repolarization; comparison with conventional CRT P. Alonso1; J. Osca1; J. Yague2; O. Cano1; P. Pimenta1; A. Andres1; S. JimenezSerrano2; J. Millet2; MJ. Sancho-Tello2 1 University Hospital La Fe, Electrophysiology Section, Cardiology Department, Valencia, Spain; 2Polytechnic University of Valencia, ITACA, Valencia, Spain Background: Cardiac resynchronization therapy (CRT) is a well-accepted therapy for patients with heart failure, left ventricular (LV) systolic dysfunction, and QRS prolongation. Although CRT improves total survival of patients with heart failure, the risk of sudden death, which is mainly due to ventricular arrhythmia, is not reduced by CRT. It has been suggested that biventricular pacing may enhance arrhythmogenicity by reversing the normal depolarization pattern from endocardium to epicardium, which enhances transmural dispersion of repolarization and allows propagation of early after-repolarizations. Data regarding the effect of conventional CRT (CONV) in ventricular repolarisation are controversial and data regarding multipoint pacing (MPP) are lacking. The aim of this study was to compare ventricular depolarisation and repolarisation parameters in patients who underwent CRT under different ventricular pacing modes (MPP Vs CONV). Methods: We recruited 38 patients who underwent a CRT device with MPP capability. Protocol study was performed three months after CRT implantation. CRT devices were programmed to deliver no pacing (or RV pacing if AV-block was present), CONV, and MPP pacing. Digital signals of surface 12-lead ECG were recorded simultaneously and ECG were analysed with a dedicated software. We measured QRS width, QT interval, and Tpeak-end. We calculated QTc, JT, JTc, JT, and QT dispersion. Results: Results: are shown in the table. Repolarization parameters (QT dispersion and Tpeak-end) showed significantly reduction when MPP was used (p¼0.003 and p¼0.04, respectively), while CONV did not reach significantly reduction of these parameters (p¼0.24 and p¼0.19). Conclusions: CRT with a MPP configuration provides a statistically significant reduction of ventricular heterogeneity of repolarization.
hs-CRP were measured at baseline and 1, 3, and 6 months after CRT implantation. Two-dimensional echocardiography was performed before and 6 months after CRT implantation for the assessment of CRT response, defined as a 15 % reduction in LV end-diastolic diameter (LVEDD) and or 10 % improvement in LV ejection fraction (LVEF). Results: The study population consisted of 90 CRT-D patients. The mean age was 64 6 9 years and 71 patients (79 %) were men. The mean LVEDD was 64 6 8 mm and the mean LVEF was 27 6 4 %. hs-CRP level was detected in all patients and 22 participants (24 %) had hs-CRP levels > 97.5th percentile. The mean hs-CRP level was 4.2 6 8.6 mg/l. Correlation analysis showed that hs-CRP levels positively correlated with LVEDD (r ¼ 0.270, p ¼ 0.040) and negatively correlated with LVEF (r ¼ 0.260, p ¼ 0.047). After 6 months of CRT, there were 42 CRT responders (47 %) and 48 CRT nonresponders (53 %). There was no significant difference in hs-CRP levels at baseline between CRT responders a CRT nonresponders (4.5 6 9.6 mg/l vs. 3.8 6 8.3 mg/l, p ¼ 0.758). However, CRT responders had significant reduction in hs-CRP levels from baseline to 6 months (from 4.5 6 9.6 mg/l to 1.7 6 2.1 mg/l, p ¼ 0.035). In contrast, no significant changes in hs-CRP levels were observed in CRT nonresponders over follow-up period. Conclusion: In the present study, we have showed that CRT can reduce hs-CRP levels in CRT responders. hs-CRP can be widely used inflammatory biomarker for monitoring of CRT response.
P1564 Full blood count parameters predict long-term outcomes in heart failure patients undergoing cardiac resynchronization therapy N. Papageorgiou; R. Providencia; A. Ioannou; D. Falconer; S. Ahsan; V. Ezzat; E. Rowland; M. Lowe; OR. Segal; P. Lambiase; A. Chow Barts Heart Centre, London, United Kingdom Background: Optimization of patient selection for Cardiac Resynchronization Therapy (CRT) is a field of active research in patients with advanced heart failure (HF), as almost a third of patients fulfilling current guidelines criteria are non-responders. Biomarkers are strong candidates to play a role in this selection, but their use has not been sufficiently addressed. Purpose: We aimed to assess the predictive role of full blood count parameters for death/transplant in HF patients undergoing CRT implantation. Methods: In this retrospective study, we included 523 consecutive patients in whom a CRT was implanted (%, n¼ with defibrillator) at our institution and had FBC obtained on the day (or just before/after) of implantation. The patients were followed up for a maximum of 13 years (median and IQR) after implantation for subsequent primary composite endpoint: death/transplantation. Haemoglobin (Hb), red cell distribution width (RDW), mean corpuscular volume (MCV) and mean platelet volume (MPV) were measured with routine methods. The mean age of the cohort was 63.2613.8 years. Results: In a Cox proportional hazards univariate model [hazard ratio (HR), 95% confidence interval (CI), Hb: 0.986 (0.979-0.993) p
