table and categorized as low risk (1 point), moderate risk (2-3 points), and

high risk (4 points) for the congenital long QT syndrome.

Results: In the study population, maximal QT interval, minimal QT

interval, mean QT interval, mean corrected QT interval, and mean RR

interval were 460 milliseconds, 280 milliseconds, 367.17 F 41.67

milliseconds, 403.65 F 31.09 milliseconds, and 799.97 F 190.67

milliseconds, respectively. A total of 30 patients (76.9%) had 1 point,

1 patient (2.6%) had 1.5 points, 6 patients (15.4%) had 2 points, 1 patient

(2.6%) got 2.5 points, and 1 patient (2.6%) had 3 points. Thus, 31 patients

(76.9%) were in the low-risk group, 8 patients (20.5%) were in the

moderate-risk group, and none was in the high-risk group according to the

congenital QT syndrome risk stratification. None of the study patients had

QTc greater than 500 milliseconds on surface ECG.

Conclusions: In conclusion, according to our study group, long QT

syndrome is not found to be a bold reason among the patients admitted to

the emergency department. However, these data must be confirmed in large

population studies.

doi:10.1016/j.jelectrocard.2007.03.164

CAR-10

Drug-induced conduction disturbances and prognosis after cessation of

the culprit drug

Murat YesSil, Erdinc Arkan, Nursen Postac, Rustem Ylmaz, Serdar Bayata

Ataturk Teaching Hospital. 1. Cardiology Department, Izmir, Turkey

Introduction: Clinical decision to implant a permanent pacemaker (PM) is

sometimes a challenge in patients with severe conduction defects,

especially in the presence of certain medications that affect on the

conduction system. The purpose of this study is to determine how often

medications cause conduction disturbances.

Methods: 167 patients (86 men; mean age, 62; range, 21-83) who were

admitted with second -degree (n = 27, 16.4%) or third-degree (n = 136,

81.4%) atrioventricular block or slow atrial fibrillation (b40/min; n = 4,

2.4%) between 2001 and 2005 were studied. Patients with acute coronary

events, vasovagal syncope, and digitalis toxicity were excluded. Conduc-

tion defect was defined by the surface ECG, and patients were followed up

clinically as long as the half lives of the drugs onboard before a decision for

a permanent PM was made.

Results: Of 167 patients, 51 (30%) were on b-blockers and/or verapamil or

diltiazem. Patients taking medications had similar rates of second- or third-

degree atrioventricular blocks and slow atrial fibrillation with patients in the

absence of drugs. Of 51 patients, 35 (68%) had to receive a permanent PM

during the hospitalization period. Patients who were discharged without a

PM were followed by Holter monitoring every 3 months for 1 year, and

recurrence of conduction disturbance was detected in 3 of 16 patients;

consequently, these patients also received PMs.

Conclusions: According to our experience, 25% of patients show

resolution of severe conduction disturbances after discontinuation of the

culprit drug. In patients who were on drugs affecting the conduction system,

it will be prudent to wait until the effects of the index drug wane before a

decision of PM implantation is made.

doi:10.1016/j.jelectrocard.2007.03.165

CAR-11

Importance of short-long-short sequences in occurrence of atrial

fibrillation in inferior acute myocardial infarction

Bulent Gorenek, AfsSin Parspur, Alparslan Birdane, Yuksel Cavusoglu,

Omer Goktekin, Ahmet Unalir, Necmi Ata, Bilgin Timuralp

Eskisehir Osmangazi Uni. Cardiology Department, Eskisehir, Turkey

Introduction: Prediction of atrial fibrillation (AF) complicating acute

myocardial infarction (AMI) is a major and largely unpredictable clinical

problem. Alterations in R-R interval precede the spontaneous onset of

paroxysmal AF. Presence of short-long-short sequence (SLSS) due to atrial

ectopic beats is a predictor of immediate recurrence of AF after

cardioversion. We aimed to investigate whether presence of SLSS, related

to atrial ectopic beats (AEBs), predicts the occurrence of AF in acute phase

of inferior myocardial infarction.

Methods: Forty-five patients (30 females; mean age, 58 F 7 years) with

inferior AMI who were in sinus rhythm on admission to hospital and

developed AF in the first 12 hours of AMI were taken to study group.

Forty-five patients (30 females; mean age, 57 F 9 years) with inferior AMI

who did not develop AF during their hospitalization were taken to control

group. Rhythm monitorization was performed for all patients in the first

12 hours of AMI in the coronary care unit.

Results: There was no difference in left atrial diameter and use of

antiarrhythmic drugs of 2 groups. Pericarditis, anemia, or hyperthyroidism

were not present in any of patients. In the 45 patients of the study group,

presence of SLSS was observed 1 minute before occurrence of AF, and in the

rest it was not present ( P b .01). In the study group, AEBs were frequent

before occurrence of AF (12.3 F 5.6 AEBs/min; average, 7.9 F 2.8 hours).

Atrial ectopic beats were less frequent in the control group in similar

detection period (4.4 F 3.8 AEBs/min; in 8.0 F 2.6 hours) ( P b .01).

Conclusions: These findings suggest that presence of frequent AEBs and

SLSS could be predictors or preceding factors of occurrence of AF in

patients with inferior AMI.

doi:10.1016/j.jelectrocard.2007.03.166

Oral Presentation

CAR-12

Atrial fibrillation in patients with obstructive sleep apnea

Ali Erdogan, Harald Tillmanns, Simon Schaefer, Burak Akcay

University, Giessen, Germany

Introduction: Patients with atrial fibrillation (AF) are associated with

higher prevalence of obstructive sleep apnea (OSA) than patients with

other severe heart diseases. Obstructive sleep apnea occurs almost

regularly in combination with apnea-synchronous cyclic modulation of

the heart rate. In 5% to 10% of the study population, SA or AV blocks are

observed during the night period. Multiple ventricular extra beats

regularly occur only with patients who have severe OSA and of coronary

artery disease at the same time. About the prevalence of AF in connection

with OSA and of the possible interaction of these 2 diseases, only few

research data can be found up to now.

Methods: Four hundred twenty-seven patients with OSA (71 female,

356 male) were studied in the sleep laboratory between 1997 and 2002, the

1-channel ECGs and other data registered (EEG, EOG, EMG, Sao2) carried

on by somnography were analyzed.

Results: Of the 427 patients, 38 (8.9%; 8 female, 30 male) had AF. A

total of 25 patients had permanent AF, and 13 paroxysmal AF. Of the

38 patients with AF, 28 (74%) had OSA, in contrast to 276 (71%)

patients out of 389 without AF ( P = .85). Patients with AF are in

average 9 years older than those without AF (median, 63.5 vs 54.5

years). In both groups, the body mass index is almost equal (median,

31 vs 30 kg/m2). In the group of patients with AF, there is a higher

number of patients with hypertonus (72.7 vs 53.3%; P = .043) and

diabetes mellitus.

Conclusions: Our findings based on a retrospective analysis revealed a

higher prevalence of AF in the OSA population than in the average

population. But if one compares the characteristics of patients with OSAwho

have AF and patients with OSAwho do not have AF, there is no evidence of

a causal link between OSA and AF. One can assume that episodes of

paroxysmal AF are triggered by repetitive apnea. Their relatively frequent

presence during sleep time indicates an association of sleep apnea and

inducible arrhythmia that was also observed by other groups.

doi:10.1016/j.jelectrocard.2007.03.167

Abstracts / Journal of Electrocardiology 40 (2007) S1–S77 S17