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DOI 10.1007/s10840-015-9975-6(2015) 42:1 – 373 26J Interv Card Electrophysiol

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Special Program and Abstract issue of the 11th Annual Congress of the European

Cardiac Arrhythmia Society (ECAS)April 19-21, 2015

Paris, France

Hotel Meriden-Etoile

Guest Editor: Prof. Samuel Lévy, MD Aix-Marseille Université, Marseille, France

ECAS Scientific Program

PROGRAM AT A GLANCE

11th Annual Congress of the European Cardiac Arrhythmia Society

SCIENTIFIC PROGRAM OF PRE-ARRANGED SESSIONS

ECAS 2015 ABSTRACT SESSIONS 1 – 4

Sunday, April 19, 2015, 10:30 AM –

12:00 PM

Abstract Session 1: Atrial fibrillation ablation

Abstract Session 2: Sudden cardiac death. Prevention and management

Abstract Session 3: Atrial fibrillation and prevention of related thromboembolism

Abstract Session 4: Mechanisms of ventricular arrhythmias

ECAS 2015 ABSTRACT SESSIONS 5 – 8 Monday, April 20, 2015, 10:30 AM – 12:00 PM

Abstract Session 5: Advances in atrial fibrillation ablation II

Abstract Session 6: Cardiac resynchronization therapy: techniques and outcome

Abstract Session 7: Mapping and ablation of ventricular arrhythmias

Abstract Session 8: Clinical and genetic aspects of ARVD/C

ECAS 2015 ABSTRACT SESSIONS 9 – 12Tuesday, April 21, 2015, 08:30 AM – 10:00 AM

Abstract Session 9: Atrial fibrillation mechanisms and management I

Abstract Session 10: Atrial arrhythmia mechanisms II

Abstract Session 11: Management of atrial arrhythmias

Abstract Session 12: Atrial fibrillation ablation III

J Interv Card Electrophysiol (2015) 42:1 – 373 26174

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ECAS 2015 POSTER SESSION A: PARTS 1 AND 2

Part 1: Supraventricular arrhythmias. Advances in mechanisms and management

Part 2: Atrial fibrillation characteristics and management

ECAS 2015 POSTER SESSION B: PARTS 1 AND 2

B Part 1: Arrhythmias and heart disease

Techniques and toolsB Part 2: Atrial fibrillation ablation

Screening athletes

ECAS 2015 POSTER SESSION C: PARTS 1 AND 2Part 1: Cardiac resynchronization therapy

Arrhythmia mechanisms

Part 2: Sudden cardiac death and implantable cardioverter defribrillator

ECAS 2015 POSTER SESSION D: PARTS 1 AND 2Part 1: Pacing and related complications

Atrial fibrillation and anticoagulant therapy

Part 2: SyncopeAblation of ventricular arrhythmias

J Interv Card Electrophysiol (2015) 42:1 – 373 26 175

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Invitation

Dear Colleagues,

This is an invitation to join us at the 11th Annual Scientific Congress of the European Cardiac Arrhythmia Society“ ECAS 2015”

to be held in Paris, France April 19 to 21, 2015, at the Meridien-Etoile Hotel (Porte Maillot). All those who attended previous

editions of ECAS Congress know that it is a highly scientific and educational event in a cheerful atmosphere which facilitates

interaction between the renowned faculty and the audience which is particularly appreciated by fellows. This edition promises to

be successful and we will be delighted to have you among us in Paris next April.

Riccardo Cappato, MD

President of ECAS

Nicolas Lellouche, MD

Congress Chairman

Xavier Jouven, MD

Scientific Program chair

EXECUTIVE COMMITTEE OF THE EUROPEAN CARDIAC ARRHYTHMIA SOCIETYPresident Riccardo Cappato (Milan, IT)

Past President Wyn Davies (London, GB)

Vice-President (Education and Research) Richard Hauer (Utrecht, NL)

Vice-President (National Societies) Massimo Santini (Rome, IT)

Vice-President (International Societies and EU) Samuel Lévy (Marseille, FR)

Treasurer Eli Ovsyshcher (Beersheba, IL)

Secretary General Leo Van Wersch (Paris, FR)

Continuing Medical Education Nicholas Peters (London, GB)

Relation with European Societies Stefan Kaab (Munich, DE)

Chair Membership Program Neil Sulke (Eastbourne, GB)

Organizing annual Congress Gerhard Steinbeck (Munich, DE)

Education Committee Thorsten Lewalter (Munich, DE)

Organizing Committee ECAS 2015


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Gerhard Steinbeck MD Samuel Levy MD Nicolas Lellouche, MD

Scientific Advisory Board

Masood Akhtar (Milwaukee, USA) Bulent Gorenek (Eskisehir, TR) Bertil S. Olsson (Lund, SE)

Etienne Aliot (Nancy, FR) Stephen C. Hammill (Rochester, USA) Oscar Oseroff (Buenos Aires, AR)

Maurits A. Allessie (Maastricht, NL) Richard Hauer(Utrecht, NL) Ali Oto (Ankara, TR)

Eckhard Alt (Munich, DE) Habib Haouala (Tunis, TN) Eli Ovsyshcher (Beersheba, IL)

Charles Antzelevitch (Utica, USA) Yoshito Iesaka (Tokyo, JP) Douglas L. Packer (Rochester, USA)Andrey Ardashev (Moscow, RU) Michiel Janse (Amsterdam, NL) Luigi Padeletti (Florence, IT)

Serge S. Barold (Boca Raton, USA) Charles Jazra (Beirut, LB) Nicholas S Peters, (London, GB)

David Benditt (Minneapolis, USA) Xavier Jouven (Paris, FR) Dubravko Petrac (Zagreb, HR)

Poul Erik Bloch-Thomsen (Hellerup, DK) Werner Jung (Villingen, DE) Eric N. Prystowsky (Indianapolis, USA)

Jozsef Borbola (Budapest, HU) Stefan Kääb (Munich, DE) Antonio Raviele(Venice, IT)

Johannes Brachmann (Coburg, DE) Prapa Kanagaratnam (London, GB) Amiran Revishvili (Moskow, RU)

A John Camm (London, GB) Joergen Kanters (Copenhagen, DK) Dwight Reynolds (Oklahoma, USA)

Alessandro Capucci (Ancona, IT) Bondo Kobulia (Tbilisi, GE) Edward Rowland (London, GB)

Riccardo Cappato (Milan, IT) Karl-Heinz Kuck (Hamburg, DE) Sanjeev Saksena (New Brunswick, USA)

David S. Cannom (Los Angeles, USA) Jean-François Leclercq (Paris, FR) Massimo Santini (Rome, IT)

Sumeet Chugh (Los Angeles, USA) Jean-Yves Le Heuzey (Paris, FR) Maurizio Santomauro (Naples, IT)

Antonio Curnis (Brescia, IT) Samuel Lévy (Marseille, FR) Dipen Shah (Geneva, CH)Philippe Coumel* Berndt Luderitz (Bonn, DE) Richard Schilling (London, GB)

D. Wyn Davies (London, GB) Damian Gascon Lopez (Sevilla, ES) Georg Schmidt (Munich, DE)

Hu Dayi (Beijing, CN) Marek Malik (London, GB) Jabir Sra (Milwaukee, USA)

Luc De Roy (Yvoir, BE) Harry G. Mond (Melbourne, AU) Gerhard Steinbeck (Munich, DE)

Sergio Dubner (Buenos Aires, AR) Alessandro A Montenero (Rome, IT) Neil Sulke (Eastbourne, GB)

Nils G. Edvardsson (Goteborg, SE) Conception Moro Serrano (Madrid, ES) Paul Touboul (Lyon, FR)

Michaël Eldar (Tel Aviv, IL) Arthur J. Moss (Rochester, NY, USA) Albert Waldo (Cleveland, USA)

Program Committee

Andrey Ardashev; Alawi Alsheikh-Ali; Serge Barold; Leonardo Calo; David S Cannom; Riccardo Cappato; Sumeet Chugh;Wyn Davies; Roberto De Ponti; Heidi Estner; Jeronimo Farre; Mark Estes III; John Fisher; Robert Hatala; Richard Hauer; Ellen

Hoffmann; Charles Jazra; Xavier Jouven (Chair); Stefan Kääb; Jean-François Leclercq; Gilles Lascault; Samuel Lévy; ThorstenLewalter; Jean-Yves Le Heuzey; Shaowen Liu; Peter Loh; Pierpaolo Lupo; Chang Sheng Ma; Michaël Näbauer; Mohan Nair;Yuji Nakazato; Andrea Natale; Petr Neuzil; Promund Obel; Eli Ovsyshcher; Douglas L Packer; Luigi Padeletti; Nicholas S.Peters; Dubravko Petrac; Antonio Raviele; Amiran Revishvilli; Sanjeev Saksena; Richard Schilling; Gerhard Steinbeck;Massimo Santini; Neil Sulke; Dorwarth Uwe; Reza Wakili; Bruce Wilkoff.


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*In memoriam

Abstract Selection

Each abstract has been sent to eight reviewers and been evaluated by a minimum of four of them.

The organizing committee would like to thank the abstract reviewers for their valuable help in the abstract selection for

the ECAS 2015 program:

Etienne Aliot; Elad Anter; Serge Barold; Jean-Jacques Blanc; Poul-Erik Block Thomsen; Gerard Boink; Gunter Breithardt; HughCalkins; Leonardo Calo; John Camm; Riccardo Cappato; Mario Delmar; Roberto De Ponti; Luigi Di Biase; Nils Edvardsson;

Nabil El Sherif; Mark Estes; Heidi Estner; Gerard Guiraudon; Sam Hanon; Richard Hauer; Bengt Herweg; Ellen Hoffman;Carsten Israel; Michiel Janse; Prapa Kanagaratnam; Helmut Klein; Yusuke Kondo; Jean-Yves Le Heuzey; Nicolas Lellouche;

Thorsten Lewalter; Berndt Lüderitz; Marek Malik; Robert Myerburg; Yuji Nakazato; Brian Olshansky; Ali Oto; Eli Ovshyscher;Dubravko Petrac; Sanjeev Saksena; Walid Saliba; Massimo Santini; Peter Schwartz; Robert Schweikert; Dipen Shah; ClaudioShuger; Jasbir Sra; Gerhard Steinbeck; Neil Sulke; Richard Sutton; Tamas Szili-Torok; Jacob Tfelt-Hansen; Antonello Vado;Peter Van Tintelen; Reza Wakili; Albert Waldo; David Wilber; Bruce Wilkoff; Roger Winkle.

General Information

Congress Venue

LE MERIDIEN ETOILE Hôtel

81 Boulevard Gouvion Saint Cyr,75848 Paris Cedex 17Tel: (33) (0)1 40 68 34 34www.lemeridienetoile.com

Congress Chairman

Nicolas Lellouche, MD Secretary:Hôpital Henri Mondor 51 avenue du Maréchalde Lattre De Tassigny94000 Créteil, France

Email: [email protected]

Sandrine BordièreTel: +33149 814350Email: [email protected]

(continued)

Nabil El-Sherif (New York, USA) Michael Nabauer (Munich, DE) Hein JJ Wellens (Maastricht, NL)Jeronimo Farre (Madrid, ES) Gerald V. Nacarelli (Hershey, USA) Bruce Wilkoff (Cleveland, USA)John Fisher (New-York, USA) Yuji Nakazato (Tokyo, JP) David Wilber (Chicago, USA)Guy Fontaine (Paris, FR) Andrea Natale (Cleveland, USA ) George D. Wyse (Calgary, CA)Robert Frank (Paris, FR) Promound I. W.Obel (Johannesburg, ZA)Seymour Furman (New York, USA)* Brian Olshansky (Iowa City, USA)


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Abstract Awards

Awardsforthe best oral abstractswill be presented during the opening ceremonyto take place on Sunday April 19, 2015, at Room DerainPresentation of the awards for best poster presentations will take place on Tuesday April 21, 2015, 12:00 PM – 12:30 PM RoomDiderot (Meridien-Etoile Hotel)11th Philippe Coumel Lecture 2015

Will be presented on Sunday April 19, 2015, from 5:30 PM to 6:00 PM as part of the opening ceremony

BadgesBadges and Final program will be available for pre-registered participants and faculty at the ECAS welcome desk, HotelMeridien Etoile, Paris, starting Sunday April 19, 2015, from 2:00 PM to 6:00 PM

ECAS Congress Secretariat

Josette RazafimbeloTel/FAX: + 33 (0)4 89 14 45 33Cell: +336 26 07 55 74E-mail: [email protected]

Registration

Registrationand payment of Congress fees as well as payment of membership dues can be done through the website. Registration

on site will start on Sunday April 19, 2015, at 8:00 AM at Hotel Meridien-Etoile.

Currency

Payment in cash for registration on site must be made in euros only. Payment using Visa credit cards will be accepted on theCongress site. Personal checks cannot be accepted.

Congress Website

All information, Scientific Program and registration to the congress, abstract submission and membership subscription withsecured payment can be done through our website http://www.ecas-heartrhythm.org

Pre-Arranged Sessions

The program includes 33 pre-arranged sessions and workshops or debates. It can be downloaded from our website as well as the

program of abstracts selected for oral or poster presentations

Publications


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Sanjeev Saksena MD

JICE Editor-in-Chief Leonardo Calo MD

Abstract Presentations

The abstracts accepted for oral or poster presentation will be published in a supplement issue of the Journal of Interventional Cardiac Electrophysiology (JICE), the official journal of ECAS provided the authors attend the congress and present their work.The oral presentation of abstracts is 10 min plus 5 min for discussion.All posters accepted for presentation will be chaired. Please check the day and time at which your poster will be presented to thechairpersons and the time at which the presenter should be near their poster board.


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PROGRAM AT A GLANCE ECAS 2015

SUNDAY APRIL 19, 2015

8:00am

5:00pmRegistration

8:30am

10:00am

Concurrent Workshops

Room TBA Room PASCAL Room DIDEROT Room DESCARTES

Session WS-06

Five year

Experience with

NOACs

Session WS-01

Atrial FibrillationablationD L Packer

Session WS-02

CardiacResynchronizationtherapyBruce Wilkoff

Session WS-03Pacemaker, ICD andCRT:Case studiesS BaroldE OvsyshcherC IsraelB Herweg

Chaired poster

session A

8:30-12:00

Coffee break

10:30am

12:00pm

Concurrent Abstract Sessions

Room DERAIN Room DIDEROT Room DESCARTES Room PASCAL Room GAUGUIN

Oral Abstract 1 Oral Abstract 2 Oral Abstract 3 Oral Abstract 4 Session A cont.

12:150pm-1:45pm 12:15pm-1:45pm

Seated Luncheon Panel 1 Seated Luncheon Panel 2

2:00pm3:30pm


Session AB-01

Pulmonary Vein

Isolation and

related strategies

Session HD-01

Inherited

potentially lethal

syndromes

Session SP-07

ECAS-WSA

New frontiers in cardiac

pacing

Session SP-02

Prevention of sudden

cardiac death

Session B

Chaired poster

3:30pm - 4:00pm: Coffee break and visit to posters

4.00pm

5:30pm


Session AB-02

Session SP-03

The MADIT Trials

Session SP-04

Intracardiac imaging

Session SP-05

Stroke prevention in

atrial fibrillation

Session B

Chaired poster

Ventriculartachycardia

ablation (I)

5:30pmRoom DERAIN Special lecture: A tribute to Philippe Coumel


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Opening ceremony

Chaired By Prof. Samuel LEVY (Marseille, FR) and Prof. Gerhard Steinbeck (Munich, DE) and

OUTSTANDING ACHIEVEMENT AWARDS Presented by

Dr Riccardo Cappato (Milan, IT ) President of ECAS

Prof. Nicolas Lellouche (Paris, FR) Congress Chairman

Dr Fernand Hessel (Mulhouse, FR) President Lucien Dreyfus Foundation

6:00pm


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MONDAY APRIL 20, 2015

8:30am

10:00am

Room COROT Room DIDEROT Room DESCARTES Room PASCALRoom

GAUGUIN

Session SP-06 Session SP-07 HRS-ECAS Session I Session AB-03 Session C

AF: beyond stroke

prevention

Sudden cardiacdeath : and left

ventricular

hypertrophy (LVH)

Arrhythmogenic

Cardiomyopathy I

catheter ablation of

complex arrhythmias

Chaired

posters

10:00am - 10:30am: Coffee break and visit to the posters

10:30am

12:00pm

Concurent Oral Abstract sessions

Room COROT Room DIDEROT Room DESCARTES Room PASCAL

Oral abstract 5 Oral abstract 6 Oral abstract 7 Oral abstract 8ChairedPosters(cont.)

12:15pm-1:45pm 12:15pm-1:45pm

Luncheon Panel 3 Luncheon Panel 4

2:00pm

3:30pm


GAUGUIN

Session AB-04Current issues inatrial fibrillation

Session HD-06

Biomarker-basedtherapeuticdecision making in AF

Session HD-07

HRS-ECAS Session ArrhythmogenicCardiomyopathy II

Session SP-15 Approaches in VT Ablation

Session D

Chairedposter

: pm - : pm: o ee rea an v s t to t e posters

4:00pm

5:30pm

Simultaneous sessions


GAUGUIN

Session AB-05 SP-14 Session SP-13 Session HD-04 Session D

AF ablation not

targetting

pulmonary veins

8th Japan HRS-

ECAS

CRT therapy

Y. Nakazato

Sudden cardiac death

Automatic nervous

system and

arrhythmias

Chaired

poster


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TUESDAY APRIL 21, 2015

8:30am

10:00am

Room DIDEROT Room DESCARTES Room PASCAL Room TBA

Oral abstract 9 Oral abstract 10 Oral abstract 11 Oral abstract 12

10:00am - 10:30am: Coffee break

10:30am

12:00pm

Room DIDEROT Room DESCARTES Room PASCAL Room TOCQUEVILLE

Session SP-11

Unresolved questions

in cardiac arrhythmias

Session SP-12

New tools and techniques

for AF

Session WS-04

Current Issues in AF

management

Session WS-05

Nightmares in catheter

ablation

12:00pm

12:30pmAbstract Poster AWARDS


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SATURDAY APRIL 18, 2015

REGISTRATION from 2:00 PM to 5:00 PM

Hotel Meridien Etoile (Lobby)

SCIENTIFIC SESSIONS


8:30 AM – 10:00 AMROOM TBA

WS-06

Five Year Experience with NOACs: Time for a First Review

Chairpersons: Jean-Yves Le Heuzey (Paris, FR), Riccardo Cappato (Milan, IT)

1. NOACs in venous thromboembolismGiancarlo Agnelli (Perugia, IT)

2. Stroke prevention of AF: Respective indications of NOAcs versus LAA device closure

Samuel Lévy (Marseille, FR)

3. NOACs in catheter ablationWyn Davies (London, GB)

4. NOACs in cardioversionRiccardo Cappato (Milan, IT)


8:30 AM – 10:00 AM

ROOM PASCAL

Workshop WS-01

Atrial Fibrillation Ablation: A New Generation of Approaches

Chairpersons: Douglas L. Packer (Rochester, USA), Karl-Heinz Kuck (Hamburg, DE)

1. Linear cold balloon therapy for persistent atrial fibrillationSuraj Kapa (Rochester, USA)

2. Impact of Contact Force Ablation on Clinical Outcomes in Patients with Atrial FibrillationDipen Shah (Geneva, CH)

3. 4 – 5 D Mapping for Intracardiac and Extracorporeal Ablation of AF

David Wilber (Maywood, USA)

4. The Biophysics of New Generation Cryoballoon and Contact Source Ablative InterventionDouglas L. Packer (Rochester, USA)


8:30 AM – 10:00 AM

ROOM DIDEROT

Workshop WS-02


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Cardiac Resynchronization Therapy

Improving Outcomes and Reducing Adverse events

Chairpersons: Bruce Wilkoff (Cleveland, USA), Helmut Klein (Munich, DE)

1. Pre-operative assessment of CRT Responsiveness

Bruce L. Wilkoff MD

2. Impact of RV pacing vs prevention of dyssynchrony

Jean-Jacques Blanc (Brest, FR)

3. Approaches to upgrading vs avoiding CRT

Mark Estes III (Boston, USA)

4. Management of atrial fibrillation in CRT Patients: PVI or AV junctional ablation

Walid Saliba (Cleveland, USA)

5. Alternatives to the CS for left ventricular pacing

Tamas Szili-Torok (Rotterdam, NL)


8:30 AM – 10:00 AM

ROOM DESCARTES

Workshop WS-03

Pacemaker ECG, ICD and CRT interpretation: Case studies

Chairpersons: Serge Barold (Tampa, USA), Eli Ovsyshcher (Beersheba, IL),Carsten Israel (Bielefeld, DE), Bengt Herweg (Tampa, USA)


8:30 AM – 12:00 PM

ROOM GAUGUIN

Chaired poster session A


10:30 AM – 12:00 PM: Concurrent Abstract oral sessions

ROOM DERAIN

Abstract session 1

ROOM DIDEROT

Abstract session 2

ROOM DESCARTES

Abstract session 3

ROOM PASCAL

Abstract session 4


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Luncheon Panels

12:15 PM – 1:45 PM 12:15 PM – 1:45 PM

Seated Luncheon Panel 1 Seated Luncheon Panel 2


2:00 PM – 3:30 PM

ROOM DERAIN

Session AB-01

Pulmonary vein isolation and related strategies

Chairpersons: Douglas Packer (Rochester, USA), Wyn Davies (London, GB)

1. AF mechanisms and role of pulmonary veins in various AF presentations

Karl-Heinz Kuck (Hamburg, DE)

2. Periprocedural dormant conduction after PV isolation: how does it affect AF recurrence?

Heidi Estner (Munich, DE)

3. Do catheter techniques make a difference in success rates?

Leonardo Calo (Rome, IT)

4. Role of autonomic ganglia in AF ablation success rates

Yusuke Kondo (Chiba, JP)


2:00 PM – 3:30 PM

ROOM DIDEROT

HD-01

Update on inherited potentially lethal syndromes

Chairpersons: Peter Schwartz (Pavia, IT), Hugh Calkins (Baltimore, USA)

1. Long QT syndrome

Peter Schwartz (Pavia, IT)

2. Cathecholaminergic polymorphic VT

Jacob Tfelt-Hansen (Copenhagen, DK)

3. Brugada syndrome

Herve Le Marec (Nantes, FR)

4. Early repolarization syndrome

Juhani Junttila (Oulu, FI)


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2:00 PM – 3:30 PM

ROOM DESCARTES

SP-07

Joint session of ECAS-WSA (World Society of Arrhythmology)

The new frontiers in cardiac pacing

Chairpersons: Massimo Santini (Rome, DE), Eli Ovsyshcher (Beer Sheba, IL)

1. 50 years of cardiac pacing: where are we now?

João Rodrigues de Sousa (Lisbon, PT)

2. The leadless pacemaker

Antonio Curnis (Brescia, IT)

3. Multipoint pacing to optimize CRT outcome

Antonello Vado (Cuneo, IT)

4. Remote control: from device to patient management

Xavier Viñolas (Barcelona, ES)

5. Advances in biological pacing

Gerard Boink (Amsterdam, NL)


2:00 PM – 3:30 PM

ROOM PASCAL

Session SP-02

Prevention of sudden cardiac death in heart disease

Chairpersons: David Cannom (Los Angeles, USA), Poul Erik Bloch-Thomsen (Copenhagen, DK)

1. Effectiveness of Automatic External Defibrillators: availability and employability

Alessandro Capucci (Ancona, IT)

2. Indications and effectiveness of wearable ICDs

Johannes Brachmann (Coburg, DE)

3. What have we learned from prophylactic ICD trials?

Robert Myerburg (Miami, USA)

4. What have we learned from ICD registries?

Robert Hauser (Minneapolis, USA)


2:00 PM – 3:30 PM

ROOM GAUGUIN

Chaired Poster session B


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3:30 PM – 4:00 PM Coffee break and Posters


4:00 PM – 5:30 PM

ROOM DERAIN

Session AB-02

Issues in ventricular tachycardia ablation (I)

Chairpersons: Nicholas Peters (London, DE), Jasbir Sra (Milwaukee, USA)

1. New insights into the VT substrate using the Rhythmia System

Elad Anter (Boston, USA)

2. Functional characterization of VT scar by ripple mapping

Prapa Kanagaratnam (London, GB)

3. Epicardial ablation of VT

Katja Zeppenfeld (Leiden, NL)

4. Ablation of bundle branch and fascicular ventricular tachycardia

Jasbir Sra (Milwaukee, USA)


4:00 PM – 5:30 PM

ROOM DIDEROT

SP-03

The MADIT (Multicenter Automatic Defibrillator Implantation) Trials

Chairpersons: David Cannom (Los Angeles, USA), Luigi Padeletti (Florence, IT)

1. Long-term prognosis of MADIT-CRT patients: new data

Mark Estes III (Boston, USA)

2. MADIT-CHAGAS study: design and early data

Claudio Schuger (Detroit, USA)

3. MADIT-CHIC study: design and early data

Jagmeet P. Singh, (Boston, USA)

4. Importance of LBBB in predicting a positive response to CRT therapy in Class I/II heart failure

David S. Cannom (Los Angeles, USA)

5. Impact of type II diabetes on the prognosis of coronary patients with heart failure: what would an ICD trial look like in

this patient group?

Helmut Klein (Munich, DE)


4:00 PM – 5:30 PM


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Room DESCARTES

SP-04

Advances in Intracardiac Imaging for Interventional Electrophysiologists: 2015 and beyond

Chairpersons: Andrea Natale (Austin, USA), Roger Winkle (Palo Alto, USA)

1. Cardiac CT for definition of left atrial appendage morphology and risk stratificationLuigi Di Biase (New York, USA)

2. Intracardiac echocardiography performed from and for the pulmonary vasculature — technique and application

Sanjeev Saksena (Warren, USA)

3. Magnetic resonance imaging of the atrial substrate and progression of atrial fibrillation: a critical analysis

Mark O’ Neill (London, GB)

4. Real-time three dimensional imaging of cardiac chambers

Mohammad Shenasa (San Jose, USA)

SUNDAY APRIL 19, 20154:00 PM – 5:30 PM

Room PASCAL

SP-05

Stroke prevention in atrial fibrillation

Chairpersons: John Camm (London, GB), Johannes Brachmann (Coburg, DE)

1. NOACs — 5 years after RE-LY: What have we learned?

Michael Näbauer (Munich, DE)

2. Interventional therapy by occluder devices — which patients should be considered?

Thorsten Lewalter (Munich, DE)

3. Ablation therapy for stroke prevention in patients with AF

John Fisher (New York, USA)

4. Role of continuous rhythm monitoring — identification of cause or bystander?

Albert Waldo (Cleveland, USA)


3:30 PM – 5:00 PM

ROOM GAUGUIN

Chaired poster session B (Cont.)

Room DERAIN

5:30 PM to 6:00 PM

Special lecture: A tribute to Philippe Coumel TBA


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Opening ceremony

Prof. Samuel Lévy (Marseille, FR) and Prof. Gerhard Steinbeck (Munich, DE)

Outstanding Achievement Awards

Best Abstracts Awards

Presented by Dr Riccardo Cappato (Milan, IT) President of ECAS

Prof. Nicolas Lellouche (Paris, FR)Congress Chairman

Dr Fernand Hessel (Mulhouse, FR) President Lucien Dreyfus Foundation

Followed by a cocktail reception


08:30 AM – 10:00 AM

ROOM COROT

SESSION SP-06

Atrial Fibrillation: Beyond Stroke Prevention

Chairpersons: Nils Edvardsson (Gothenburg, SE), Amiran Revishvili (Moscow, RU)

1. Cardiovascular Morbidity and Mortality of AF

Christine Albert (Boston, USA)

2. Atrial Fibrillation and Sudden Cardiac Death

Eloi Marijon (Paris, FR)

3. Role of Pharmacology

Juan Tamargo (Madrid, ES)

4. Role of Catheter Ablation

Walid Saliba (Cleveland, USA)


08:30 AM – 10:00 AM

ROOM DIDEROT

Session SP-07

Sudden cardiac death: Focus on at risk patients with secondary left ventricular hypertrophy (LVH)

Chairpersons: John Fisher (New-York, USA), Dubravko Petrac (Zagreb, HR)


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ECG and MRI criteria of LVH

James Harrison (London, GB)

Mechanism of ventricular arrhythmias in patients with LVH

Nabil El-Sherif (New York, USA)

Risk stratification of patients with LVH at risk of sudden cardiac death

Gerhard Steinbeck (Munich, DE)

Regression of LVH and clinical outcome

Ariel Cohen (Paris, FR)


08:30 AM – 10:00 AM

ROOM DESCARTES

Session HD-03

HRS-ECAS SPECIAL SESSION I

Arrhythmogenic Cardiomyopathy IDiagnosis and Mechanisms

Chairpersons: Peter Van Tintelen (Amsterdam, NL), Connie Bezzina (Amsterdam, NL)

History of the disease

Guy Fontaine (Paris, Fr)

Advantages/limitations of the Revised Task Force Criteria

Richard Hauer (Utrecht, NL)

Pathogenicity of genetic variants

Dennis Dooijes (Utrecht, NL)

Role of substructures in the Intercalated disk

Mario Delmar (New York, USA)


08:30 AM – 10:00 AM

ROOM PASCAL

AB-03

Highly technologic approach in catheter ablation of complex arrhythmias

Chairpersons: Richard Schilling (London, GB), Andrey Ardashev (Moscow, RU)

1. 3-D mapping and contact force sensing in ablation of atrial fibrillation

Roberto De Ponti, (Varese, IT)

2. Remote navigation ablation of atrial fibrillation and flutter using remote manipulation of multiple catheters

Eugene Crystal (Toronto, CA)


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3. Preprocedural imaging and 3-D mapping in patients with ventricular tachycardia associated with structural heart

disease

Richard Schilling (London, GB)

4. 3-D mapping and contact force sensing in ablation of idiopathic ventricular tachycardia

David Wilber (Chicago, USA)

MONDAY APRIL 20, 201508:30 AM – 10:30 AM

ROOM GAUGUIN

Chaired Poster session C Part 1

10:00 AM – 10:30 AM Coffee break and Posters


10:30 AM – 12:00 PM

Concurrent Oral Abstract sessions

ROOM COROT

Abstract session 5

ROOM DIDEROT

Abstract session 6

ROOM DESCARTES

Abstract session 7

ROOM PASCAL

Abstract session 8

12:15 PM – 1:45 PM Room Dufy 12:15 PM – 1:45 PM

Luncheon Panel 3 Luncheon Panel 4


2:00 PM – 3:30 PM

ROOM COROT

SESSION AB-04

Current issues in atrial fibrillation

Chairpersons: Antonio Raviele (Venice, IT), Leonardo Calo (Rome, IT) TBC

Patients Selection: Do we already need updated guidelines?

Riccardo Cappato (Milan, IT)

Periprocedural Anticoagulation for AF ablation with warfarin and NOACs: beyond clinical stroke prevention

Etienne Aliot (Nancy, FR)


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Energy Sources and tools: To whom, when and why?

New generation cryothermia balloon

Ellen Hoffmann (Munich, DE)

Laser balloon ablation

Thomas Deneke (Bad Neustadt, DE)

Lesion visualization and future directions

Matthew Wright (London, GB)


2:00 PM – 3:30 PM

ROOM DIDEROT

SESSION: HD-06

Biomarker-based therapeutic decision making in atrial fibrillation

Chairpersons: Stefan Kääb (Munich, DE), Nicholas Peters (London, GB)

Biosignals — AF complexity guiding treatment strategies?

Ulrich Schotten (Maastricht, NL)

Biomarkers for the patient at risk for AF

Moritz Sinner (Munich, DE)

Genetics of AF — Ready for clinical decision making?

Stefan Kääb (Munich, DE)

MicroRNAs — Potential biomarkers for AF and AF therapy?

Reza Wakili (Munich, DE)


2:00 PM – 3:30 PM

ROOM DESCARTES

HD-07

HRS-ECAS SPECIAL SESSION

ECAS-HRS Joint Special Session (organized by Richard Hauer)

Arrhythmogenic Cardiomyopathy II

Risk Stratification and Therapy

Chairpersons: Corrina Brunckhorst (Zurich, CH), Richard Hauer (Utrecht, NL)

1. Electrophysiologic substrate and risk stratification

Alessandro Zorzi (Padova, IT)

2. Long-term Follow-up of ICD Therapy in ARVD/C

Hugh Calkins (Baltimore, USA)


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3. Towards Elimination of the Electrophysiologic Substrate

Francis Marchlinski (Philadelphia, USA)

4. Towards New Drug Therapy

Jeffrey Saffitz (Boston, USA)


2:00 PM – 3:30 PM

ROOM PASCAL

SP-15

Approaches in VT Ablation

Chairpersons: Francis Marchlinski (Philadelphia, USA), Walid Saliba (Cleveland, USA)

1. Mechanisms of VT in structural heart disease

Michiel Janse (Amsterdam, NL)

2. Ischemic cardiomyopathy: The homogenization approachAndrea Natale (Austin, USA)

3. VT ablation in non-ischemic cardiomyopathy

Jasbir Sra (Milwaukee, USA)

4. The impact of pre and post VT ablation inducibility on long-term success, re-hospitalization and mortality.

Gerhard Hindricks (Leipzig, DE)


2:00 PM – 5:00 PM

ROOM GAUGUIN

Chaired Poster presentation D

3:30 PM – 4:00 PM Coffee break and Posters


4:00 PM – 5:30 PM

ROOM COROT

AB-05

AF ablation techniques not targeting the pulmonary veins

Chairpersons: Riccardo Cappato (Milan, IT), David Wilber (Maywood, USA)

1. Detection and role of non-pulmonary vein AF triggers

Richard Schilling (London, GB)

2. Targeting complex fractionated atrial electrograms

Julien Seitz (Marseille, FR)


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3. Mapping techniques for detecting rotors

Omer Berenfeld (Ann Arbor, USA)

4. Rotors-based AF ablation strategies

Paul Wang (Stanford, USA)


4:00 PM – 5:30 PMROOM DIDEROT

SP-14

8th Japanese HRS/ECAS SYMPOSIUM

New Insights in CRT therapy

Chairpersons: Yuji Nakazato (Chiba, JP), Gilles Lascault (Paris, FR)

1. Impact of multisite LV pacing in heart failure patients

Werner Jung (Villingen, DE)

2. Trans-septal endocardial LV pacing

Hidemori Hayashi (London, GB)

3. Role of surgical approach: An update

Katsuhiko Imai (Hiroshima, JP)

4. Clinical efficacy of optimization algorithm

Toshiiyuki Ishikawa (Yokohama, JP)


4:00 PM – 5:30 PM

ROOM DESCARTES

SP-13

Sudden cardiac death on a population level — Stratification methods for the patient with ejection fraction >35 %

Chairpersons: Stefan Kääb (Munich, DE), Brian Olshansky (Iowa City, USA)

1. Epidemiology of SCD

Xavier Jouven (Paris, FR)

2. ECG — Risk stratification for SCD

Pieter Postema (Amsterdam, NL)

3. Holter-ECG: Potential parameters for risk stratification

Marek Malik (London, GB) TBC

4. Genetics of SCD — What have we learned?

Vincent Probst (Nantes, FR)


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4:00 PM – 5:30 PM

ROOM PASCAL

HD-04

Role of the autonomic nervous system in cardiac arrhythmias

Chairpersons: Gunter Breithardt (Muenster, DE), Shlomo Ben Haim (London-GB)

1. Role of multimodal imaging in arrhythmia patients

Reza Wakili (Munich, DE)

2. Risk stratification by autonomic biosignaling

Axel Bauer (Munich, DE)

3. Role of sympathetic innervation in ARVD patients

Matthias Paul (Munich, DE)

4. Autonomic testing for risk stratification in Long-QT patientsPeter Schwartz (Milan, IT)

5. Renal Denervation — A treatment option for ventricular storm tachycardias

Noel Boyle (Los Angeles, USA)


4:00 PM – 5:30 PM

ROOM GAUGUIN

Chaired Poster session D (Cont.)


5:30 PM – 6:15 PM

ROOM COROT

Debate 1

Successful RF ablation alone is an acceptable treatment for monomorphic, well-tolerated VT with an ejection fraction

above 30 %

Chairpersons: Francis Marchlinski, (Philadelphia, USA), Gerhard Steinbeck (Munich, DE)

Protagonist: Philippe Maury (Toulouse, FR)

Antagonist: Brian Olshansky (Iowa City, USA)


5:30 PM – 6:15 PM

ROOM DIDEROT

Debate 2


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Chairpersons: Berndt Lüderitz (Munich, DE), Pro Obel (Johannesburg, ZA)

Rhythm control in patients with atrial fibrillation should not be pursued vigorously in the post AFFIRM era?

Protagonist: A. John Camm (London, GB)

Antagonist: Sanjeev Saksena (Warren, USA)


5:30 PM – 6:15 PM

ROOM PASCAL

Debate 3: Right ventricular apical pacing should be abandoned

Chairpersons: Luigi Padeletti (Florence, IT), Pascal Defaye (Grenoble, FR)

Protagonist: Carsten Israel (Bielefeld, DE)

Antagonist: Eli Ovsyshcher (Beer Sheba, IL)


08:30 AM – 10:00 AM

ROOM DIDEROT

Abstract session 9

ROOM DESCARTES

Abstract session 10

ROOM PASCAL

Abstract session 11

ROOM TBA

Abstract session 12

Coffee Break


10:30 AM – 12:00 PM

ROOM DIDEROT

Session SP-11

Unresolved questions in the management of cardiac arrhythmias

Chairpersons: Edward Rowland (London, GB), Maurice Khoury (Beirut, LB)

1. How to interpret short runs of AF on Holter monitoring?

Taya V. Glotzer (Hackensack, NJ, USA)


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2. How much redo after a first AF ablation procedure?

David Keane (Dublin, IE)

3. Does revascularization prevent SCD?

Gerard Guiraudon (London, CA)4. How safe are PVC’s in patients without structural heart disease?

Charles Jazra (Beirut, LB)

5. Ablation of PVCs: When and how?

Oussama Wazni (Cleveland, USA)


10:30 AM – 12:00 AM

ROOM DESCARTES

SP-12

New tools and techniques for AF therapy

Young German electrophysiologists — Session of the German EP Fellow program

Chairpersons: Reza Wakili (Munich, DE), Roland Tilz (Hamburg DE)

1. Potential role of multimodal mapping for a better understanding of the AF substrate

Armin Luik (Karlsruhe, DE)

2. Role of continuous ECG monitoring by implantable loop recorders

Joern Schmitt (Giessen DE)

3. The nMARQ-catheter: initial experience and results

Stephanie Fichtner (Munich DE)

4. Rotor mapping: do different tools lead to different results?

Roland Tilz (Hamburg, DE)


10:30 AM – 12:00 AM

ROOM PASCAL

WS-04

Current Issues in AF management

Chairpersons: Roberto de Ponti (Varese, IT), Michiel Janse (Amsterdam, NL)

1. Remodelling and Anti-arrhythmic Agents

Dobromir Dobrev (Essen, DE)

2. Monitoring Ablation Outcomes — what really happens to AF?

Neil Sulke (Eastbourne, GB)


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3. Thoracoscopic Surgery and Hybrid Therapy Outcomes

Alaadin Yilmaz (Amsterdam, NL)

4. Hot versus Cold — The latest outcomes of CRYO and RF techniques in paroxysmal and persistent AF

Ross Hunter (London, GB)


10:30 AM – 12:00 AM

ROOM TOCQUEVILLE

WS-05

Nightmares in catheter ablation: case presentations

Chairpersons: Riccardo Cappato (Milan), Ali Oto (Ankara, TR)My worst case of …

1. Atrial flutter ablation

Isabel Deisenhofer (Munich, DE)

2. Atrial fibrillation ablation

Nicolas Lellouche (Paris, FR)

3. Accessory pathway ablation

Peter Loh (Utrecht, NL)

4. Ventricular tachycardia ablation

Bharat Kantharia (Houston, USA)


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Abstract oral session 1: Atrial fibrillation ablation

Sunday, April 19, 2015, 10:30 AM – 12:00 PM

1 – 1 Abstract 18 – 21

EFFECT OF ANTIARRHYTHMICS DRUG INIT

IATION ON READMISSION AFTER CATHETER

ABLATION FOR ATRIAL FIBRILLATION

Peter Noseworthy1 , Hol ly Van Houten 1 , LindseySangaralingham1, Abhishek Deshmuk 1, Suraj Kapa1, SivaMulpuru1, Christopher McLeod1, Samuel Asirvatham1, NilayShah1, Douglas Packer 11 Mayo Clinic, Rochester, MN, United States

Background: Hospital readmission, a commonly tracked indica-tor of quality and efficiency of care delivery, occurs in about 15 % patients within 90 days of undergoing catheter ablation for atrial fibrillation (AF). We sought to evaluate the impact onantiarrhythmic drug(AAD) initiation on the riskof readmission.

Methods and Results: Using a large national administrativeclaims database, we identified all atrial fibrillation patients(age ≥ 18 years) who underwent catheter ablation between2005 and 2013. We identified the subset of patients who had

not been on an AAD in the 90 days prior to the ablation (n=2542) and, among those, the patients in whom an AAD wasinitiated within 7 days of the ablation (n=826). A total of 387(15.2 %) patients were readmitted within 90 days of ablation for any cause, and 161 (6.3 %) were readmitted with atrial fibrilla-tion or atrial flutter as the primary discharge diagnosis. Thereadmission rate was significantly lower among patients who

were initiated on an antiarrhythmic drug compared to those whowere not (11.7 vs. 16.9 %, p=0.0007). In a multivariate model,age 65+years, Charlson index of ≥ 3, CHADS2 score of ≥ 3,and year of service in 2009 – 2010 were significantly associatedwith risk of readmission ( p

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from an interim analysis of the first multicentre randomised con-trolled trial studying the impact of this data on the ablation of

paroxysmal atrial fibrillation (PAF). METHODS: At seven UK centres, patients undergoing first-time PAF ablation wererandomised to ablation with (CF-on) or without CF data (CF-off) available to the operator. Planned recruitment is 120 patientswith 1-year follow-up. Using a 3D mapping system and the

SmartTouch CF-sensing catheter (Biosense Webster), all patientsunderwent WACA. Subsequently a 1-h waiting time was ob-served before assessingacutepulmonaryvein(PV)reconnection;if the PV remained isolated, 18 mg adenosine was administeredintravenously. The primary end point was acute PVreconnection(spontaneous/adenosine induced). PVs were assessed separately,

but cases of a common trunk were taken as one vein. PVs that

appeared isolated but were assessed without completing thewaiting period were excluded from the acute reconnection anal-ysis. Follow-up is ongoing and 3-month outcomes are reported.RESULTS: One hundred sixteen patients have been recruited:age 59±11 years, 57 % male, EHRA score 2.7±0.6 and AFduration 37 [16 – 70] months (no significant baseline characteris-tic differences between groups). There were no differences in

procedural parameters (Table). There was a significant, 40 %,reduction in acute PV reconnection in the CF-on group (Table).There were two tamponades and one minor pericardial effusionin the CF-on group, and one minor hematoma in the CF-off group. Ninety patients (43 CF-off, 47 CF-on) have completed3-month follow-up: at this point, there is no difference in EHRAscores (CF-off 1.6±0.6, CF-on 1.5±0.6, p=0.8).

CONCLUSIONS: Addition of CF sensing data had no impact on procedure, fluoroscopy or ablation times, but did reduceacute PV reconnection rates, suggesting more effective abla-tion application and consequently more durable PV isolation.

Whether this translates to improved long-term success will beassessed on study completion.

1 – 3 Abstract 18 – 26

PAROXYSMAL ATRIAL FIBRILLATION ABLATION

WITHOUT PULMONARY VEIN ISOLATION

Clement Bars1, Julien Seitz2, Guillaume Theodore3, AngeFerracci2, Michel Bremondy2, Jacques Faure2, André Pisapia21 Institut Mutualiste Montsouris, Paris, France; 2 Hôpital Saint

Joseph, Marseille, France; 3University Hospital, Nice,

France

Background: Pulmonary vein isolation (PVI) is the most pop-ular approach for paroxysmal atrial fibrillation (PAF) ablation.This method is a probabilistic one and do not specificallytarget AF substrate which could lead either to under- or over-treatment. Objectives: We aimed to evaluate in PAF anelectrogram substrate ablation technique guided by regional

high-density mapping. Methods: We analysed the PAF sub-group of the SUBSTRATE HD study (multicentric study withseven operators involved). Twenty-four patients undergoingPAF ablation were thus prospectively enrolled for a first abla-

tion procedure (mean age=61.7+10.25). A substrate biatrialhighdensity mapping with a 20-pole-contact electrodePentaRay NAV catheter (Biosense Webster) was performed.AF substrate was detected both automatically with a newCFAE algorithm setting and visually by operators (continuousCFAE and temporal gradient of activation). Ablation end

points were AF termination (sinus rhythm or atrial tachycardiaconversion), sinus conversion and non-inducibility (“atrialdevulnerabilisation”). Results: AF was induced in 16 patients(66.6 %) by rapid atrial pacing. The median mapping timesand number of acquisition points/patient in the right and left atria were, respectively, as follows: 7 [4 – 7] and 14 [9.25 – 15]

min with 569 [285 – 739] and 831 [1052 – 490] points. Sub-strate ablation without PVI terminated AF in 23/24 (96 %)

patients in 15.3+14.8 mean min RF time. Sinus rhythm wasrestored in 23/24 (96 %) patients and non-inducibility wasachieved in 75 %. The total mean procedure and RF timewere, respectively, 153.9+ 36 and 43 min +18.4. No procedur-al complications occurred. After a mean follow-up of 6.5+2.8 months 23/24 (96 %), patients were free from AF and

CF-off group CF-on group p value Number 60 56

Total procedure time (min) 195 [165 – 216] 193 [171 – 219] 0.97

Total fluoroscopy time (min) 13 [6 – 23] 10 [6 – 30] 0.96Total fluoroscopy dose (cGy.cm2) 904 [292 – 1684] 813 [365 – 2187] 0.88

Total radiofrequency ablation rime (s) 2446 [1898 – 2862] 2446 [2023 – 2956] 0.46

Total pulmonary vein acute reconnections 68/227 (30 %) 38/202 (18 %) 0.01

Left pulmonary vein acute reconnections 35/115 (30 %) 17/103 (17 %) 0.017

Right pulmonary vein acute reconnections 33/112 (30 %) 21/99 (21 %) 0.2


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19/24 (79.16) were free from any atrial arrhythmias. Conclu-sion: Electrogram-based substrate ablation guided by bi-atrialhigh-density mapping for PAF without PVI is feasible, safe,reproducible and efficient.

1 – 4 Abstract 18 – 16

PREDICTION OF AF ABLATION OUTCOME: THECAAP-AF SCORE

Roger Winkle1, Julian Jarman2, R. Hardwin Mead1, GregoryEngel1, Melissa Kong1, William Fleming1, Rob Patrawala11Silicon Valley Cardiology, E Palo Alto, CA, USA; 2 Royal

Brompton Hospital, London, UK

Objectives: To develop a clinical scoring system to predict thefinal outcome for all patients undergoing atrial fibrillation (AF)ablation. Methods: We examineda development cohort (DC) of 1125 consecutive patients undergoing 1.34±0.53 AF ablations

from 2003 to 2010. Results: Pt. demographics were as follows:age=62.3±10.3, male=71.2 %, LA size=4.30±0.69 cm, par-oxysmal AF 30.9 %, drugs failed=1.3±1.1, hypertension=46.7 %, diabetes=8.9 %, prior CVA/TIA=6.9 %, prior cardio-version=46.9 % and CHADS2=0.87±0.97. Multivariate anal-ysis showed six independent variables predicting outcome after final ablation: CAD ( p=0.021), atrial diameter ( p=0.0003), age( p=0.004), persistent or longstanding AF ( p

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1 – 6 Abstract 18 – 25

USE OF CONTACT FORCE TECHNOLOGY IN AF

ABLATION PROCEDURES DOES NOT IMPROVE

CLINICAL OUTCOME RATES — INSIGHTS FROM

A 3 YEAR SINGLE CENTER EXPERIENCE

Stefan Sattler 1, Johannes Siebermair 1, Eva Klocker 1, Lucia

Olesch1, Samira Saraj1, Ina Klier 1, Christoph Schuhmann1,Sebastian Clauss1, Moritz Sinner 1, Stephanie Fichtner 1,Stefan Kääb1, Heidi Estner 1, Reza Wakili11 Medical Department I, Klinikum Grosshadern, Ludwig-

Maximilians-University, Munich, Germany

Introduction: Pulmonary vein isolation (PVI) is an establishedmethodto treat atrial fibrillation(AF). Contact force (CF) sensingcatheters have been introduced with the purpose to improve pro-cedural parameters and clinical outcome of AF ablation. In this

study, we evaluated >300 PVI procedures regarding the role of CF catheters with respect to procedural parameters and mid-termclinical outcome. Methods: We performed an analysis of a totalof 302 patients with paroxysmal (n=141) or persistent AF (n=161) undergoing PVI; patients were divided into two groups: (1)n=158, ablation performed with CF sensing SMARTtouch cath-eter© (ST) aiming for a CF>10 g/lesion, and (2) n=144, patientsundergoing PVI with a standard ablation catheter (SAC). Com-

plete electrical isolation of all PVs was considered as proceduralendpoint (PE). FU was performed on regularly basis by 7-dayECG Holter recordings in 6 months terms. Results: Patient char-acteristics regarding percentage of paroxysmal AF, male gender,age, LA size, LV ejection fraction, history of hypertension or concomitant structural heart disease did not differ significantly

between both groups. PE was reached in all patients.Applicationof CF measurement feature in the ST group did result in a sig-nificant reduction of whole procedure time (232±151 vs. 269±57 min, ** p

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17 vs. 38±17, ** p

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(SCD) after unexplained syncope without cardiomyopathy, on patients with or without ER. Methods: From January 2009 toDecember 2013, all patients hospitalized for unexplained syn-cope, presenting J wave elevation ≥0.1 mV in at least twoinferior (II, III, aVF) and/or lateral leads (V4 – V6, I, aVL)from 23 centers, have been included in a prospective registry.Their outcome was compared with patient admitted in Uni-

versity Hospital of Bordeaux on the same period, without cardiomyopathy nor ER. Referring physicians managed the

patients according to their local practice. Results: One hun-dred patients were included in ER group (84 (84 %) males, 33±16.5 years old), 53 (53 %) received an implantable looprecorder (ILR). During a mean follow-up of 31.8±17.9 months, and 11 (11 %) experienced a ventricular arrhyth-

mia (10 VT (figure) and 1 SCD). In the group without ER (n=139, 84 (60 %) males, 51±19 years old), 70 (50.4 %)had an ILR. During a mean follow-up of 36.8± 19.7 months,4 (2,8 %) had a ventricular arrhythmia (2 VT and 2 SCD).ER was associated with an increased hazard ratio (HR) for ventricular arrhythmia of 5.07 (IC95 % [1.61 – 16.0], p=0.03) and 4.55 (IC95 % [1.17 – 17.8], p=0.029) when ad-

justed on sex. In ER group, only inferior ER was associatedwith arrhythmia. J wave amplitude, ER pattern, ST segment aspect, regional and transmural dispersions of repolariza-tion were not associated with a different outcome. Conclu-sions: ER pattern after an episode of unexplained syncopeis associated with an increased risk of ventricular arrhythmia.


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2 – 2 Abstract 19 – 24

DAYTIME AND SEASON AS PREDICTORS

FOR CARDIAC RHYTHM DISTURBANCES IN DIFF

ERENT DISEASES — A LARGE REAL-LIFE ANAL

YSIS

Eimo Martens1, Johannes Siebermair 1, Regina Freeden2,Carsten Koenig2, Stefan Veith1, Moritz Sinner 1, Stefan Kääb11 Klinikum der Universität München, Muenchen, Germany; 2-

Medtronic GmbH, Meerbusch, Germany

Background. SCD underlies until now a not-understood circa-dian rhythm during the day and during the year. Only for asmall part of the SCD predictors are known. Implantablecardioverter-defibrillator (ICD) systems are well establishedto prevent sudden cardiac death (SCD). It is important to un-derstand the predictors for rhythm disturbances to identify

patients at risk for SCD. Objective. The objective of this anal-

ysis was to retrospectively investigate the temporal distribu-tion of rhythm disturbances of ICD patients in dependence of clinical patient parameters. Methods. Anonymized follow-updata of ICD and CRT-D of the time between 2002 and 2014were collected and pooled from our clinic. Data were analyzedin a database that allows the collection of follow-up from ICD

programmer as well as telemedicine transmissions. Within thedatabase, all parameters as well as EGMs, episode- and

patient-data is stored and can be analyzed. Physicians classi-fied the occurrence of appropriate vs. inappropriate therapy or episode type. Results. Data were analyzed from 8300 follow-ups of 704 patients (952 ICD/CRT-D devices). We specified

79 % male, mean age 66±13 years, 62,7 % primary preven-tion, 55 % ICM, 39 % DCM and 6 % other diseases. Wedetected 4888 episodes overall, thereof 1369 with relevant rhythm disturbances. Eight hundred ninety-nine VT episodes(median cycle length 409 ms) and 470 VF episodes (mediancycle length 231 ms) were found. For VF episodes, we couldfind a significant peak around 8 pm ( p=0.03, Fig. 1) for pri-mary and secondary prevention patients. For VT episodes, it was in contrast to the overall distribution a significant peak found in ICM patients in the early morning ( p=0.02, Fig. 2).During the year, we found significant higher incidence of VFand VT episodes in April (primary and secondary prevention)

and September/October (secondary prevention) (Figs 3 and4). In ischemic patients, significantly more episodes occur inApril; patients with dilative cardiomyopathy showed signifi-cant higher incidence of episodes in September (Fig. 3). Con-clusion. ICD patients have relevant VT and VF episodes dur-ing their life. Underlying disease and the difference between

primary and secondary prevention cause significant different distribution of VF and VT episodes during the day and theyear. It is the duty of further investigations to investigate thedaily or yearly predictors for the higher incidence rate.

2 – 3 Abstract 19 – 25

RANOLAZINE AMELIORATES

POST-RESUSCITATION ELECTRICAL INST

ABILITY AND MYOCARDIAL DYSFUNCTION AND

IMPROVES OUTCOME IN A RAT MODEL OF VENT

RICULAR FIBRILLATION

Francesca Fumagalli1, Ilaria Russo1, Lidia Staszewsky1,Roberto Latini1, Antonio Zaza2, Giuseppe Ristagno11 IRCCS-Istituto di Ricerche Farmacologiche “ Mario Negri” ,

Milan, Italy; 2 Dipartimento di Biotecnologie e Bioscienze,

Università degli Studi Milano-Bicocca, Milan, Italy

Dysregulation of intracellular Ca2+ homeostasis plays a criti-cal role in the pathophysiology of cardiac arrest and cardio-

pulmonary resuscitation (CPR), leading to ventricular arrhyth-mias and left ventricle (LV) dysfunction. We investigated theeffects of the INaL blocker ranolazine on outcome of CPR.

Methods. Eighteen rats were assigned to receive intravenousranolazine, 10 mg/kg, or vehicle. Ventricular fibrillation (VF)was then induced and untreated for 8 min. CPR was then

performed for 8 min. ECG, arterial, and right atrial pressureswere monitored up to 3 h after CPR. LV function was moni-tored by echocardiography, and 72-h survival was evaluated.Incidence, frequency, and duration of ventricular arrhythmiaswere quantified. Effects of ranolazine on VF waveform fea-tures were assessed by measuring the amplitude spectrum area(AMSA), peak (PF), median (MDF), mean frequency (MNF),and root mean square amplitude (RMS). Results. All animalsin the ranolazine group were resuscitated and survived up to

72 h, whereas 72 % in the vehicle group were resuscitated and54 % survived. AMSA and RMS were consistently higher inanimals pretreated with ranolazine ( p

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resuscitation, LV systolic and diastolic functions were better in ranolazine group ( p

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tion in sudden death from lowest to highest SPRM quartiles(low to high proportion sudden death) was 19, 57, 78, and 95 %( p=0.55, 0.02, 0.007,and0.003, respectively).TheICDbenefit varied markedly for all-cause mortality across SPRM quartilesfrom a 10 % increase in the 1st quartile to decreases of 28, 47,and 66 % in the 2nd to 4th quartiles ( p=0.38, 0.055, 0.01,0.001, respectively). Conclusions. Although a primary preven-

tion ICD in SCD-HeFTreduced sudden death by 62 % and all-cause mortality by 27 %, the benefit is not uniform. In SCD-HeFT, the reduction in sudden death and all-cause mortalitywas confined to those with a higher proportional risk of suddendeath, whereas patients in the lowest quartile of SPRM risk hadno mortality benefit from the ICD. The SPRM can be a real-time tool to identify individuals who are most appropri-ate for a primary prevention ICD.

2 – 6 Abstract 19 – 30

IMPLANTABLE CARDIAC DEFIBRILLATOR

IN THE SETTING OF TETRALOGY OF FALLOT

Abdeslam Bouzeman1, Guillaume Duthoit 2, MagalieLadouceur 1, Raphael Martins3, Maxime De Guillebon4,Laurent Fauchier 5, Pascal Defaye6, Jean-Baptiste Gourraud7,Jean-Marc Sellal8, Pierre Mondoly9, Fabien Lalombarda10,Frederic Anselme11, Linda Koutbi12, Nicolas Lellouche13,Franck Halimi14, Anne Messali15, Amel Mathiron16, NicolasSadoul8, Laurence Iserin1, Pierre Bordachar 4, NicolasCombes17, Jean-Benoit Thambo4, Eloi Marijon11Paris Cardiovascular Research Center, Inserm U970, Paris,France/European Georges Pompidou Hospital, Paris, France/

Paris Descartes University, Paris, France; 2CHU La PitieSalpetriere Hospital, Cardiology Department, Paris, France;3CHU Pontchaillou, Cardiology Department, Rennes, France;4CHU Haut Leveque, Cardiology Department, Bordeaux,France; 5CHU Trousseau, Tours, France; 6CHU Michallon,Grenoble, France; 7CHU Nantes, Nantes, France; 8CHUBrabois, Nancy, France; 9Hopital Rangueil, Toulouse, France;10 CHU Caen, Caen, France; 11CHU Rouen, Rouen, France;12CHU La Timone, Marseille, France; 13CHU Henri Mondor,Creteil, France; 14Hopital Prive Parly II, Le Chesnay, France;15CHU Bichat, Paris, France; 16CHU Amiens, Amiens,France; 17Clinique Pasteur, Toulouse, France

Background — Tetralogy of Fallot (TOF) is the most frequent form of congenital heart disease managed by EP physicians

for potential implantable cardioverter defibrillator (ICD).However, few studies have reported long-term outcomes of TOF patients with ICD. Methods — Between 2005 and 2014,all TOF patients with ICD in 17 French centers were enrolledin a specific evaluation aiming to determine characteristics at implantation as well as outcomes (overall mortality, appropri-ate ICD therapies, and device-related complications). Re-

sults — Overall, 78 patients were enrolled with a mean age at implantation of 45± 13 years. Fifty patients (64 %) were male.A majority of patients were implanted in the setting of sec-ondary prevention (73 %), whereas the remaining (27 %) in

primary prevention. Among the latest group, characteristics,known as risk factors of appropriate therapy, were observed asfollows: important pulmonary regurgitation in 30 %, prior

palliative shunt in 50 %, syncope with unknown origin in25 %, inducible ventricular tachycardia in 45 %, QRS dura-tion ≥180 ms in 18 %, non-sustained ventricular tachycardiain 25 %. In addition, 45 % had documented sustained supraventricular tachycardia, and 30 % presented symptoms of

heart failure. Twenty-eight patients (37 %) finally received asingle-chamber ICD, 37 patients (49 %) dual chamber and 8

patients (11 %) had ICD with resynchronization therapy. After a mean follow-up of 4.9± 3.8 years, 35 patients experienced at least one appropriate therapy (45 %): 25 % appropriate thera-

py in the primary prevention group compared to 53 % of patients in the secondary prevention group ( P =0.45). Themean time between ICD implantation and the first appropriatetherapy was 2.2±3.2 years. Overall, ≥one ICD-related com-

plication occurred in 30 patients (38 %), including inappropri-ate shock (n=9), major pocket hematoma (n=1), lead dys-function (n=12), infection (n=4), shoulder algodystrophia

(n=2), device failure or dislodgement needing reintervention(n=2). Eventually, four patients were transplanted (5 %), andsix patients (8 %) died during the course of follow-up (includ-ing two without previous appropriate therapy). Conclusions — Considering relatively long-term follow-up, patients withTOF and ICDs experience high rates of appropriate ICD ther-apies, in both primary and secondary prevention. Major ICD-related complications remain, however, high. Selection of can-didates, especially for primary prevention implantation, re-mains challenging and may be improved in the future.

Abstract oral session 3: Atrial fibrillation and prevention

of related thromboembolism



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3 – 1 Abstract 15 – 25

PERSISTENT LEFT ATRIAL APPENDAGE

THROMBUS IN NON-VALVULAR ATRIAL

FIBRILLATION AND RISK OF

THROMBOEMBOLISM

Omer Iqbal1, Yassar Nabeel1, Hardik Doshi1, Lee Joseph1,Prashant Bhave1, Miriam Zimmerman1, Michael Giudici11University of Iowa Hospitals and Clinics, Iowa City, IA, USA

Background: In patients with non-valvular atrial fibrillation(NVAF), a transoesophageal echocardiogram (TEE) is usually

performed to rule out left atrial appendage (LAA) thrombus prior to initiating rhythm control, in order to reduce the risk of thromboembolism (TE). When thrombus is detected by TEE, arepeat study is often performed after 3 – 4 weeks of continuousoral anticoagulation in order to document resolution of thethrombus prior to restoring sinus rhythm. There are few data

assessing TE risk in patients with NVAF who have TEE whichdocument thrombus. We conducted this study to quantify theTE risk in such patients. Methods: A single-center retrospectivereview identified 65 patients with NVAF who were found tohave LAA thrombus on TEE and had a CHA2DS2VASCscoreof at least 1 between 2002 and 2014. Depending on subsequent TEE findings, they were dividedinto threegroups: patients with

persistent LAA thrombus (PLAAT) [ N =15], resolved LAAthrombus (RLAAT) [ N =13], and unknown LAA thrombusevolution (ULAAT) in patients with no repeat TEE [ N =37].TE event rates per person-year and all-cause mortality in thesegroups were assessed. Results: Median follow-up was

1.93 years (PLAAT), 1.91 years (RLAAT), and 0.49 years(ULAAT). Actual thromboembolic events/person-year were4.2 (ULAAT), 0.36(PLAAT), and 0.03(RLAAT). The ULAATgroup had higher TE event rates when compared to PLAAT( p=0.006) or RLAAT ( p

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Results: A total of 400 patients (200 patients in each group)were included in the study. The average age was 65.9±9.9 years with 286 (71.5 %) male and 334 (83.5 %) patientshaving non-paroxysmal AF. There were no differences in ma-

jor (1 vs. 0.5 %, p=1.0), minor (3.5 vs. 2.5 %, p=0.56), andtotal bleeding complications (4.5 vs. 3 %, p=0.43) between theapixaban and the warfarin group, respectively. There were no

symptomatic thromboembolic complications. All the dMRIswere negative for SCI in the apixaban group.Conclusions: Uninterrupted apixaban administration in pa-tients undergoing AF ablation appears to be feasible and ef-fective in preventing clinical and silent thromboembolicevents without increasing the risk of major bleedings.

3 – 3 Abstract 15 – 28

HYPERACUTE AND CHRONIC CHANGES IN

CEREBRAL MAGNETIC RESONANCE IMAGES

AFTER PVAC, NMARQ AND EPICARDIAL

THORACOSCOPIC SURGICAL ABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION

Conn Sugihara1, Neil Barlow1, Emma Owens1, DavidSallomi1, Steve Furniss1, Neil Sulke11 East Sussex Healthcare NHS Trust, Eastbourne, UK

Background: Asymptomatic cerebral events (ACEs) detectedwith cerebral MRI immediately post AF ablation have beenreported with a number of AF ablation techniques. Methods:Patients ablated with either PVAC, nMARQ or thoracoscopicepicardial surgical AF ablation had cerebral MRIs performed

before, immediately after and 3 months after ablation. AllMRIs were independently reported by three radiologists

blinded to treatment assignment, in two phases. Firstly, MRIswere anonymised, randomised and examined individually.Then, each patient ’s MRIs were compared in sequence to look for new changes. Results: Fifty-four patients (mean age65 years, median CHA2DS2-Vasc score 2) were analysed.Sixty-five percent of patients received an immediate post-ablation MRI. Prior to ablation, although no patient had a prior history of cerebral infarction (CI), 15.6 % of patients had MRIevidence of CI, and 84.4 % had white matter change (WMC).Of all scans, 8.3 % were reported to have a lesion consistent

with an ACE. However, most ACEs appeared on the baselineor 3-month scans, hence were not ablation-related. OnceMRIs were compared in sequence, two ACEs on the hyper-acute scan were shown to be pre-existing. There were two(13.3 %) PVAC patients, one (6.7 %) nMARQ patient andno surgical patients with ablation-related ACE. Three monthsafter ablation, there were no new CIs detected, but 43 % of

patients had evidence of progressive white matter change. No patient had any clinical neurological abnormality detected at any time during the study period. Conclusions: There was ahigh background rate of asymptomatic cerebral lesions in pa-tients undergoing AF ablation. The majority of ACEs were not ablation-related. Cerebral MRIs in AF patients demonstrated avery high rate of both baseline undocumented, and rapidly

progressive, asymptomatic cerebrovascular disease. The clin-ical relevance of cerebral MRI changes in AF ablation remainsunclear.

3 – 4 Abstract 15 – 51

RIVAROXABAN AND TWO DOSAGES DABIGATR

AN VERSUS WARFARIN IN PATIENTS WITH HIGH

RISK OF STROKE AND EMBOLISM UNDERGOING

ELECTRICAL CARDIOVERSION WITH PERS

ISTENT AND LONG-ACTING ATRIAL

FIBRILLATION

Oskars Kalejs1, Olga Litunenko2, Aldis Strelnieks3, SandisSakne1, Milana Zabunova1, Marina Kovalova4, GalinaDormidontova5, Iveta Sime6, Natalija Pontaga5, KasparsKupics1, Maija Vikmane1, Janis Guslens7, Aivars Lejnieks3,Andrejs Erglis11 P. Stradins Clinical University Hospital, Riga, Latvia; 2 Riga

Stradins University, Riga, Latvia; 3 Riga East University Hos-

pital, Riga, Latvia; 4 Jelgava Regional Hospital, Jelgava,

Latvia; 5 Daugavpils Regional Hospital, Daugavpils, Latvia;6 Liepaja Regional Hospital, Liepaja, Latvia; 7 Riga Technical

University, Riga, Latvia

Background. The important factor of safety in patients withatrial fibrillation (AF) undergoing electrical cardioversion(ECV) is appropriate use of oral anticoagulants (OAC). Novelanticoagulants (NOAC) are a possible alternative to warfarin.Methods. We have analysed the data in 1512 patients (pts)undergoing ECV. One thousand one hundred ninety-three AFdefined as persistent and 319 as long-standing mean CHA2DS2 VASc score was 3.6±1.9; 1025 had one or two ECV inhistory. Nine hundred seventy-three (64.3 %) pts started the useof NOAC: dabigatran (D) 405 pts 150 mg twice or 302 pts110 mg twice or 266 rivaroxaban (R) 20 mg daily before

ECV for at least 21 days, 539 (35.6 %) started warfarin (W)and 21 days start after INR was in range 2.0 – 3.0. One hundredten milligrams twice were prescribed for pts ≥ 75 years old,HASBLEED risk score ≥3 and k i dney probl ems.Transoesophageal echocardiography (TEE) was encouraged

before ECV in all groups for pts with CHA2DS2VASc score≥ 4, left atrial dilatation and AF duration ≥ 6 months. ECG and


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echo data were analysed 30 and 90 days after ECV. Results.ECV was successful after first shock in 1239 (92 %) pts, totalsuccess ECV — in 1318 (97.9 %) pts. Left atrial thrombi weredetected on TEE before ECV in 31 pts in NOAC group and 28

pts in W group, so pts continued OAC therapy for 2 monthsand TEE had been performed again. Nine pts in D (150 mgtwice), 6 pts in R (20 mg od) group and 5 pts in W group were

free of thrombus and have been referred for ECV. Average timeof treatment before ECV was significantly lower for NOAC(25 days) than with W (48 days, p

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1 Paracelsus Medical University, Nuremberg Hospital, Dept.

of Vascular and Endovascular Surgery, Nuremberg,

Germany; 2 Paracelsus Medical University, Nuremberg Hos-

pi ta l, De pt . of Ca rdi ol og y/ Rh yt hm olog y, Nu remb erg ,

Germany

Acute peripheral ischemia of the upper extremity [API] is a

disease with standardized procedure in diagnostic and ther-apy in vascular surgery. In addition to specific vascular therapy, one has to search for the source of the embolus.In most cases, the embolus originates from the heart, due tostructural or rhythmological diseases. When atrial flutter or fibrillation [AF] is detected, the indication for permanent oral anticoagulation [OAC] is given. Chad2sVasc2-Indexsupports risk stratification and decision making. But with-out the proof of AF, the level of cardiologic andrhythmologic investigations is uncertain, also the need for OAC. The aim is to evaluate the incidence of recurrent embolic events during long-term follow-up after primary

API and its correlation with AF-associated risk factors. Weanalysed hospital records of patients with API referred toour department in 2005 for the diagnosis of peripheral em-

bolisation, stroke, heart rhythms, cardiac disorders andvascular diseases. Medical course as well as surgical ther-apy and medication at discharge were documented. Addi-tionally, we screened our hospital database for recurrent embolic events up to 2013. In 2005, 16 patients attendedour hospital with the diagnosis of API (mean age 73.6 years±0.6a). At admission, the surface electrocardiogram [ECG]showed AF in 10 patients; 6 patients were in sinus rhythm[SR]. In 10 out of 16 patients, a transthoracic echocardiog-

raphy for embolus screening was performed; no patient with SR received a long-term-ECG [TL-ECG] to rule out AF. Mean Chad2sVasc2-Score was 3.62±2.0 over all, and3.67±1.97 in SR group. While patients with AF receivedOAC, SR patients were treated only with acetylsalicylicacid [ASS] 100 mg/day. During follow-up period, recur-rent embolic events occurred in 4 of 6 patients in SR group:2 cases of embolisation of the upper extremity, 1 stroke, 1transitoric ischemic attack. At the time of the recurrent event, 3 of 4 patients were in SR, in one nothing wasdocumented. One was under therapy of ASS; no patient was treated with OAC. Our retrospective study shows that

examination for the source of embolic events in patientswith API is inadequate. Patients with peripheral embolismhave a high risk according to the Chad2sVasc2-Score. Dur-ing long-term follow-up, the rate of recurrent embolicevents is high, even if SR is documented. Therefore, a

prospective trial with long-term follow-up is needed toevaluate the efficiency of a standardized diagnostic work-up including LT-ECG and a risk adopted anticoagulationstrategy for secondary prevention of recurrent embolicevents.

Abstract oral session 4: Mechanisms of ventricular

arrhythmias


4 – 1 Abstract 01 – 12

PREVALENCE OF RIGHT VENTRICULAR ENDOCARDIAL BIPOLAR LATE POTENTIALS

IN BRUGADA SYNDROME

Luigi Sciarra1, Ermenegildo De Ruvo1, Chiara Lanzillo1,Alessio Borrelli1, Antonio Scarà1, Marco Rebecchi1,Alessandro Fagagnini1, Marta Marziali1, Lucia De Luca1,Domenico Grieco1, Ludovica Scialla2, Elisa Salustri3,Annamaria Martino1, Leonardo Calò11Cardiologia - Policlinico Casilino, Italia, Italy; 2Cardiologia -

Policlinico Umberto I, Rome, Italy; 3Cardiologia - Università

de L’ Aquila, L’ Aquila, Italy

Introduction: Brugada syndrome (BS) is considered to be an “electrical” disease in structurally normal hearts.The electrophysiological substrate of the syndrome isnot clarified. Late potentials (LPs) are bipolar signalsoccurring after the QRS complex and have been identi-fied as good target for VT ablation in structural heart disease. Delayed ventricular activity has been identifiedin a limited population of symptomatic BS patients at the anterior epicardial aspect of the right ventricular outflow tract (RVOT). Aim of our study: We aim toassess the presence of endocardial right ventricular LP

in a BS population. Methods: We studied 10 patients(mean age 38±13 years; 7 males) with BS. Diagnosisof BS was based on the typical ECG alterations: 9 pa-tients showed spontaneous “type 1” pattern; in 5 pa-tients ,we observed a coved type pattern after flecainideinfusion. Control group: Eight patients (mean age 47±17 years; six males) without structural heart disease un-dergone to an ablation for atrio-ventricular nodal re-entrant tachycardia. Every subject underwent to right ventricular electroanatomical mapping with the Carto3system (Biosense Webster). Low-voltage areas are areaswith a local voltage >1.5 and

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areas. In the 4 patients without LP, we did not find anylow-voltage or scar area. All patients with BS and evi-dence of LP showed a type 1 pattern ECG patter at thetime of endocardial mapping. Conclusions: Endocardial

bipolar LPs are common in patients with BS and aremainly located at the RVOT. Our results need to beconfirmed in larger series and could be important for

future therapeutical developments in high risk BS pts.

4 – 2 Abstract 02 – 11

SLOWING OF CONDUCTION VELOCITY VIA

GAP-JUNCTIONAL UNCOUPLING IS SUFFICIENT

TO CAUSE ELECTROGRAM FRACTIONATION

Shaun Selvadurai1, Emmanuel Dupont 1, Caroline Roney1, Norman Qureshi1, Fu Siong Ng1, Rasheda Chowdhury1, Nicholas Peters1

1 Imperial College London, London, UK

Electrogram fractionation is commonly used to identifyareas of abnormal electrical activity to guide catheter ab-lation. Cellular mechanisms for this fractionation remainlargely unknown. In silico modelling questions whether cell-cell coupling can lead to fractionation. We aimed toinvestigate if conduction slowing by cellular uncouplingalone was sufficient to lead to an increase in electrogramfractionation in an in vitro simple cell model. A monolay-er of HL-1 cell line myocytes was seeded onto 8×8 mi-croelectrode arrays (100 mm electrodes/ 700 mm spacing)

and loaded with voltage sensitive dye di-8-ANEPPS.Carbenoxolone (gap-junction uncoupler) was adminis-tered in incremental doses (0 – 50 μ M). After 5 min of stabilisation, electrogram recordings were taken while op-tical images were simultaneously recorded. Administra-tion of carbenoxolone resulted in up to 65 % conductionslowing ( p

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4 – 4 Abstract 02 – 14

CELLULAR CHARACTERISATION OF STROMAL

CELL AND CARDIOMYOCYTE COUPLING AT THE

CRITICAL ISTHMUS IN AN IN VIVO SWINE

MODEL OF POST-INFARCTION RE-ENTRANT

VENTRICULAR TACHYCARDIA

Tarvinder Dhanjal1, Nicolas Lellouche2, Chris Von Ruhling1,David Edwards1, Chris George1, Alan Williams11Wales Heart Research Institute, Cardiff, UK; 2 Henri Mondor

Hopital, Paris, France

Introduction: Electroanatomical- and MRI-based mapping techniques have defined the critical isthmus (CI)in the post-myocardial infarction (MI) re-entrant VT

circuit as heterogeneous areas of myocardium withinthe scar border zone (BZ). In vi t ro studies showmyofibroblast-cardiomyocyte (MFB-CM) coupling re-sults in slow conduction, a pre-requisite for re-entry.However, the nature and extent of functional coupling

between MFBs and CMs in vivo remains controversial.

We have performed a comprehensive evaluation of thestructural relationship between surviving CMs and stro-mal cells at the VT CI. Methods: All studies are per-formed according to the position of the European UnionDirective 2010/63/EU and approved by the Animal Carea n d U s e C o m m i tt e e o f t h e C e nt r e H o sp i t al i e r Universitaire Henri Mondor (INSERM U955). Domestic

pigs underwent MI induction. The VT study was per-formed after 6 weeks with a substrate, pace and entrain-ment mapping approach to identify scar, BZ, CI, late


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potent ials and LAVAs. Electroanatomic-histologicaloverlay was achieved with three epicardial location

points assigned to the map and markers sutured at thecorresponding locations prior to explantation and histo-logical analysis. Results: Table 1 shows voltage charac-teristics of VT-inducible (n=6) and non-inducible (n=6)

pigs. Histological analysis was focused on five distinct

regions: (1) VT CI sites, (2) BZ regions not VT CI, (3)LAVAs, (4) dense scar and (5) normal myocardium.Immunohistological analysis assessed cell-type-specificmarkers identifying CMs, MFBs and fibroblasts withregional extracellular matrix composition. Furthermore,the distribution and magnitude of connexin (37, 40, 43and 45) and cadherin (pan, OB and N) coupling be-tween MFBs and cardiomyocytes was defined. Conclu-sion: This study demonstrates key electrophysiologicaland histological differences in the post-infarct VT induc-ible heart and novel insights in the cellular compositionand architecture of the VT CI which forms the basis for

further molecular investigation which may lead to improved VT CI targeting for catheter ablation.Table 1. Characterisation of post-MI myocardium associatedwith non-inducible and inducible VT

4 – 5 Abstract 01 – 233

THE DEVELOPMENT OF A NOVEL SYSTEM FOR

THE STUDY OF CARDIAC

ARRHYTHMIA — SIMULTANEOUS

MEASUREMENT OF CALCIUM TRANSIENTS AND

ELECTRICAL ACTIVITY IN MURINE CARDIAC

TISSUE

Alastair Yeoh1, Malcolm Finlay2, Naomi Anderson3, StephenHarmer 3, Andrew Tinker 31UCL and QMUL, London, UK; 2 Barts Health NHS Trust

and QMUL, London, UK; 3

QMUL, London, UK

Introduction: More effective diagnosis and treatment of cardiac arrhythmia requires a deeper understanding of

the underlying pathophysiology of arrhythmia. Existingresearch primarily employs single-cell or whole-heart models, but there is a translational gap between theselevels of study. This study describes the development of a novel system to simultaneously measure calcium andelectrophysiology at the tissue level, intended to bridgethe gap between cell and organ research. Methods: A

combined calcium fluorescence and solid-state electricalrecording system was set up on an inverted microscope.Samples of murine tissue were loaded with a fluorescent calcium indicator dye (Fluo-4AM). Intracellular calciumtransients (elicited by electrical stimulation via externalelectrodes) were recorded by a CMOS digital camera,which measured emission light from samples excitedwith a narrow wavelength LED. The validity of thiscalcium imaging system was assessed by measuringthe effects of decreased cycle length and pharmacologi-cal agents on calcium transients. Electrical and fluores-cence data were then obtained simultaneously. Electrical

data were recorded by contact electrodes in a multi-electrode array. Results: Tissue was successfully loadedwith fluorescent dye and calcium transients (observed asincreases in green fluorescence, Figure) elicited by elec-trical stimulation were recorded. Calcium transient height and duration decreased by 19 % ( p

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4 – 6 Abstract 17 – 13

MELATONIN AND OMACOR INCREASE THRE

SHOLD TO INDUCE VF AND NORMALIZE

MYOCARDIAL CONNEXIN-43 EXPRESSION IN

FEMALE RATS EXPOSED TO HIGH SUCROSE DIET.

Tamara Benova1, Csilla Viczenczova1, Jana Radosinska2,Vladimir Knezl3, Barbara Bacova1, Jana Navarova3,Branislav Obsitnik 4, Jan Slezak 1, Narcisa Tribulova11 Institute for Heart Research, Slovak Academy of Sciences,

Bratislava, Slovakia; 2 Institute of Physiology, Faculty of Med-

icine, Comenius University, Bratislava, Slovakia; 3 Institute of

Experimental Pharmacology & Toxicology, Slovak Academy

of Sciences, Bratislava, Slovakia; 4St. Elisabeth Institute of

Oncology, Bratislava, Slovakia

Rationale and purpose: Abnormal localization and/or dysfunc-

tion of cardiac connexin-43 (Cx43) channels have been impli-cated in the occurrence of life-threatening arrhythmias. Our

previous studies indicate that diabetes is associated with Cx43and PKC-epsilon alterations linked with slower conduction.To elucidate the impact of glucose metabolism disorders ondevelopment of Cx43 alterations and susceptibility of theheart to inducible VF, we examined female rats that underwent high sucrose diet. Moreover, we tested antiarrhythmic effectsof melatonin and Omacor® and possible implication of Cx43in this condition. Design and methods: The experiment was

performed on 9-month-old female Wistar rats that were divid-ed into four groups: (1) controls, (2) rats drinking 30 % su-

crose solution (HSD), (3) HSD supplemented with melatonin(40 μ g/ml in drinking water) and (4) HSD supplemented withomega-3 fatty acids (Omacor, 25 g/kg per diet). Left ventriclewas used for analysis of Cx43 mRNA and protein levels aswell as protein expression of PKCÎμ (which phosphorylatesCx43) and PKCÎ’ (which is implicated in pro-apoptotic sig-naling). Electrically inducible sustained VF was examinedusing isolated-perfused heart. Results: High sucrose diet result-ed in an increase of body weight, adiposity, plasma triglyceridesand cholesterol as well as heart and left ventricular weight. Thethreshold to induce sustained VF was lower in rats exposed tohigh sucrose diet, while both melatonin and Omacor significant-

ly increased it. There were no changes in Cx43mRNA amongthe groups. However, melatonin normalized the decreased Cx43

protein expression and its phosphorylation in HSD rats. Omacor did not affect total Cx43 levels, but enhanced functional phos-

phorylated forms of Cx43. Moreover both, melatonin andOmacor normalized diminished expression of PKCe and elevat-ed expression of PKCd in rats exposed to high sucrose diet.Conclusions: Findings indicate that high sucrose diet of femaleWistar rats results in downregulation of myocardial Cx43 andPKC signaling that may be related to the increased susceptibility

of these rats to malignant arrhythmias. The adverse effectscan be attenuated by the treatment with either melatoninor Omacor. This work was supported by VEGA 2/0046/ 12, 1/0032/14, 2/0167/15, 2/0021/15 and APVV0241/11, 0348/12 grants.

Abstract oral session 5: Advances in atrial fibrillation

ablation II

Monday, April 20, 2015, 10:30 AM – 12:00 PM

5 – 1 Abstract 04 – 13

SITES OF ATRIAL FIBRILLATION ROTORS MAY

OVERLAY GANGLIONATED PLEXI IN LEFT

ATRIUM

Tina Baykaner 1, Junaid Zaman2, Theodoros Zografos3,

Ioannis Pantos3, David Krummen1, Demosthenes Katritsis3,Sanjiv Narayan41University of California, San Diego, San Diego, CA, USA, 2

Imperial College London, London, UK; 3 Athens Euroclinic,

Athens, Greece; 4

Stanford University, Palo Alto, CA, USA

Introduction: The cardiac autonomic nervous system playsan important role in atrial fibrillation (AF). Recent advancesin mapping human AF report localised sources (rotors) treat-able by focal ablation. We hypothesised that such rotors mayco-localise with ganglionated plexi (GP). Methods: We stud-ied 70 consecutive patients with AF (61.1±8.6 years, 73 %

persistent) recorded with 64 pole contact catheters (Constel-lation, BSCI) and phase mapping of AF singularities (rotors)at EP study. Electroanatomic shells were analysed indepen-dently by four blinded observers for overlap with superior/ inferior left GPs (SLGP, ILGP) or anterior/inferior right GPs(ARGP, IRGP). GP locations were referenced to a database.Results: AF sources arose in 68/70 (97 %) patients with amean of 2.1±1.0/each (left atria, LA 1.4±0.8, right atria, RA1.0±0.7). Of all patients, 65 patients had LA sources. Of these, 55 patients (85 %) had at least 1 rotor that co-localised with a GP, either definitely (24 patients, 27 %) or

possibly (31 patients, 48 %). Out of 96 LA rotors identified,

only 15 were not related to any GP. The figure shows 3targeted rotors overlapping GP, and 1 RA rotor with noGP overlap. There was a correlation between increasingnumber of LA rotors and the likelihood of a rotor coincidingwith a GP site ( p

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5 – 2 Abstract 28 – 16

FEASIBILITY OF A NON-INVASIVE ELEC

TROCARDIOGRAPHIC MAPPING SYSTEM AT

LOCALISATION OF ECTOPY TO GUIDE ABLATION

IN PATIENTS UNDERGOING REPEAT CATHETER

ABLATION FOR ATRIAL FIBRILLATION

Norman Qureshi1, Cheng Yao2, Shahnaz Jamil-Copley1,Michael Koa-Wing1, Sajad Hayat 1, Fu Siong Ng1, AfzalSohaib1, Elaine Lim1, Ian Wright 1, Nick Linton1, DavidLefroy1, Zachary Whinnett 1, Nicholas Peters1, PrapaKanagaratnam1, Phang Boon Lim1, D Wyn Davies1

1 Imperial College, London, UK; 2 CardioInsight Technologies,

Cleveland, OH, USA

Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. Long-term outcomes

with PVI are plagued with recurrences necessitatingmultiple procedures. The major causes of recurrenceare PV re-connection and non-PV triggers. We used anon-invasive electrocard

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