six months. Interventions: 12 sessions of controlled supervised exercise protocol within a cardiac rehabilitation program and educational program. Main outcomes: The main outcome in the study were the PRO-BNP level at 8 weeks the secondary outcomes were VO 2 changes in the exercise test functional capacity and quality of life. Evidence level: 1. Results: 23 patients were included in the intervention group and 26 in the control group. Five patients died, six did not complete the evaluation, and one patient did not perform the exercise test. 17 patients were analyzed in the intervention group and 20 in the control group. After completing the supervised exercise program PRO-BNP and VO 2 levels did not change in a statistically significant way between the groups. The quality of life evaluated with the medical outcome study (SF-36) improved in the intervention group on the next dimensions: change in health status perception (p 0007) emotional performance (p 0011) physical perfor- mance (p 0006) physical function (0024) mental health (p 0009) and overall health (p 001). Conclusion: A supervised exercise program in patients with heart failure does not modify the PRO-BNP leves or the VO 2 at 8 weeks however it does improve health related quality of life. No. 18 Benefits of Cardiac Rehabilitation in Heart Failure Patients Receiving Continuous-Flow Left Ventricular Assist Device in Early Postoperative Period. Chen-Yu Hung; Ssu-Yuan Chen; Shoei-Shan Wang; Ching Lan. Objective: To investigate the effect of cardiac rehabilitation (CR) on the exercise capacity, physiological variables of ventilatory efficiency during submaximal exercise and health-related quality of life (HRQOL) among heart failure patients receiving the second-generation continuous-flow left ventricular assist device (LVAD) in early postoperative period. Design: Case series study. Setting: CR center in a tertiary hospital. Participants: Clinically stable heart failure patients who received continuous-flow LVAD implantation during 2011-2013 at a university hospital were recruited for this study. Interventions: Outpatient CR. Main Outcome Measures: We performed cardiopulmonary exercise testing (CPET) at baseline and after CR. The outcome variables included peak oxygen uptake (peak VO 2 ), peak workload ventilation-to-carbon dioxide output (VE/VCO 2 ) slope, oxygen uptake efficacy slope (OUES) and oxygen uptake efficiency plateau (OUEP). The HRQOL was evaluated by the medical outcomes trust 36-item health survey (SF-36). Level of Evidence: Level 3 evidence. Results: Four patients (age 44.5 Æ 6.2 years; 3 men 1 woman) participated in a 2-month outpatient CR program at 35 Æ 12 days after LVAD implantation. After CR obvious increase in peak VO 2 (13.1 Æ 2.0 to 16.3 Æ 1.1 ml/kg/min), peak workload (54 Æ 14 to 73 Æ 16 watt), OUES (1228 Æ 229 to 1590 Æ 318 ml/min/log (l/min)), OUEP (31.0 Æ 4.6 to 33.5 Æ 1.9 ml/l) and decreased VE/VCO 2 slope (35.8 Æ 2.7 to 31.1 Æ 4.3) were observed. Increase of SF-36 HRQOL scores was also observed in physical functioning (58.8 Æ 8.5 to 77.5 Æ 22.2) and role physical (18.8 Æ 37.5 to 50.0 Æ 57.7). Conclusions: CR is safe and beneficial for exercise capacity ventilatory efficiency and HRQOL in heart failure patients using continuous-flow LVAD in early postoperative period. No. 19 Effects of Music and Exercise Combination on Cardiac Autonomic Nervous System. Tiantian Jia; Yoshiko Sakata; Misa Miura; Masahiro Kohzuki. Disclosure: None. Objective: Exercise increases sympathetic nervous activity. The exercise-induced sympathetic activation could trigger fatal events such as ventricular arrhythmia and sudden cardiac death. Previous studies reported that music increased parasympathetic nervous activity. Music may therefore attenuate the exercise-increased sympathetic nervous activity. To establish this hypothesis we investigated effects of music and exercise combination on cardiac autonomic nervous system. Design: Cross-over study. Setting: Listening to music and exercise. Participants: Thirty healthy adults. Interventions: Subjects partici- pated in four sessions on four separate days: 1) a music session 2) a bicy- cling session 3) a music and bicycling session and 4) a sedentary session. Subjects were asked to listen to their favorite music in the music session, to exercise on a cycle ergometer in the bicycling session, and to exercise while listening to the music in the music and bicycling session. Each session proceeded for fifteen minutes. Main Outcome Measures: Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and cardiac autonomic nervous activity. Level of Evidence: level 1 (likely reliable). Results: Music significantly decreased HR, SBP, and DBP accompanied with the significant increase of high frequency power (HF) which was obtained an index of parasympathetic nervous activity by power spectrum analysis of heart rate fluctuations. Exercise significantly increased HR and the ratio of low frequency power to HF (L/H) which indicated the sympathetic nervous activity whereas it significantly decreased HF. Exer- cise and music combination did not significantly increased L/H and not decreased HF. Conclusions: This study demonstrated that music increased the parasympathetic nervous activity and tended to attenuate the exercise-increased sympathetic nervous activity in healthy adults. Music may be an effective approach for preventing fatal cardiac events during exercise. No. 21 Accuracy of Heart Rate Measurement Using Smartphone and Prototype Application During Treadmill Exercise. Se-Eung Noh, M.D; Jin-Seok Lee Deng; Hyun-Jun Kim; Min-Cheol Joo. Objective: To evaluate the accuracy of heart rate measurement by using smart phone (i-Phone 4s Apple, USA) and application (Atrial Fibrillation Diagnostic Prototype Application, Department of Biomedical Engineering, Wonkwang University School of Medicine Iksan, Republic of Korea) during treadmill exercise. This study is a preliminary study for development of cardiac rehabilitation exercise smartphone applications. Setting: Heart rate check during treadmill exercise. Participants: 29 healthy adult volun- teers. Intervention: To measure heart rate, volunteers grabbed smartphone in hand and index finger placed on the camera of an iPhone 4s for 1 minute. The iPhone 4s can record a pulsatile photo-plethysmogram signal from fingertip using the built in camera lens and the prototype application can analyze pulse rate fluctuation. Bruce protocol was used for treadmill exer- cise. They were measured heart rate at resting stage, during exercise at Bruce Stage II, Bruce Stage III, and recovery stage by the prototype application using iPhone 4s and EKG telemetry (Q-Tel Cardiac Science Waukesha, Wisconsin, USA). And we compared both methods. Main Outcome Measures: The error rates percent ¼{[｜Application HR e EKG Heart Rate｜/ EKG Heart Rate ] x 100 } Result: The average heart rates of application and EKG telemetry were 75.0Æ12.8 and 77.2Æ12.0, 113.1Æ16.6 and 114.7Æ17.1, 156.8Æ15.3 and 162.1Æ13.3, 99.8Æ11.9 and 102.4Æ11.41 in resting stage, Bruce Stage II, Bruce Stage III, and recovery stage. The error rates were 3.8%Æ2.6%, 3.3%Æ2.7%, 4.2%Æ4.0%, and 3.8%Æ2.9% in resting stage, Bruce Stage II, Bruce Stage III, and recovery stage. Average error rates were increased slightly in exercise stages than resting stage. Conclusion: The results showed low average error rate percent, so we think it possible to develop a home cardiac rehabilitation exercise application. In the future using the proven diagnostic function of this application we think it can be possible to develop a real-time cardiac monitoring application. No. 22 The Paradox of Obesity and Its Relationship to Cardiorespiratory Fitness in Patients With Heart Failure. Robinson Ramírez-Vélez; Lisbeth Triviño-Quintero; Juan Carlos Ávila. Disclosure: None. Objective: The aim of this study was to evaluate the relationship between the “obesity paradox” with cardiorespiratory PM&R Vol. 6, Iss. 8S2, 2014 S101