ABSTRACTS Heart, Lung and Circulation S15 2010;19S:S1–S35 Abstracts particularly ACE, is associated with improved outcomes including increased EF and fewer MACE. Conflict of interest: None. doi:10.1016/j.hlc.2010.04.030 30 CARDIAC IMPLANTABLE ELECTRONIC DEVICE HOME MONITORING AT WAIKATO HOSPITAL: AN INITIAL EXPERIENCE C Hor * , M Liang, S Heald, MK Stiles Waikato Hospital, Hamilton Background: Cardiac Implantable Electronic Devices (CIED) with Home Monitoring technology have recently become available. We aimed to look at the impact of Home Monitoring capability on the management of our early cohort of patients with CIED. Waikato DHB provides CIED follow-up for the Midland Region (870,000 people): Tairawhiti to Taranaki. Methods: We reviewed 14 patients with a Home Monitoring-capable CIED inserted at Waikato Hospital since February 2007. Information was obtained from the Home Monitoring website and clinical notes. Results: The mean age was 64 years (range: 36–81); 9 males. CIEDs included standard pacemakers (1), resyn- chronisation therapy pacemakers (1) and implantable cardioverter-defibrillators (ICD) (12). Four ICDs were implanted for primary prophylaxis indications. Mean follow-up was 10.5 months (range 1.75 to 36.5 months) and median travelling time 60minutes (range: 5 to 390). Ten patients generated alarms; 4 were classified as ventricular tachycardia; the remainder were of little clinical signifi- cance. One patient had her treatment plan modified prior to next follow up as a direct result of the early notification via Home Monitoring. Another was able to defer a planned flight from a peripheral hospital for CIED interrogation due to the reassuring data provided by transmission. Conclusion: These data demonstrate the potential use- fulness of CIED Home Monitoring. This is of particular relevance given the large area our service covers. It is hoped this method of CIED monitoring may safely reduce the frequency of “in-person” attendances and minimise travel for this patient population. Conflict of interest: None. doi:10.1016/j.hlc.2010.04.031 31 THE POTENTIAL ROLE OF COMPUTED TOMOGRA- PHY CORONARY ANGIOGRAPHY (CTCA) FOR THE DETECTION OF SIGNIFICANT CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING VALVULAR SURGERY J Huang * , J Yeoh, R Gabriel, T Sutton, N Van Pelt Middlemore Hospital, Auckland, New Zealand Background: Computed tomography coronary angiog- raphy (CTCA) is proving to be an accurate non-invasive imaging modality to rule out significant CAD (defined as at least 1 major coronary vessel with >50% diameter loss), and may be a safe and cost effective technique for the ini- tial evaluation of patients prior to valvular surgery. The aim of this study is to identify patient factors that could guide the choice of CTCA over invasive coronary angiography (ICA) as the initial investigative modality in pre-surgical valvular patients. Methods: A retrospective clinical audit was performed to determine the prevalence and severity of CAD in con- secutive valvular surgery patients who had ICA as part of standard pre-surgical assessment between May 2006 and May 2008. The Duke Clinical Probability Score was utilised. Results: 70 patients (mean age 59 yrs, 70% male) were evaluated. 25 (40%) had significant CAD. Patients with sig- nificant CAD were older (66 vs. 62, p = 0.24), more likely to have type 2 diabetes (12 vs. 7, p = 0.02) and previous history of CAD (20 vs. 7, p < 0.0001). A previous history of IHD was associated with the presence of significant CAD (sensi- tivity 80%, specificity 81%). On receiver operator curves, a Duke clinical score cut off of 81 was predictive of significant CAD (sensitivity 80%, specificity of 81%). Conclusion: CTCA may be an alternative to ICA prior to cardiac surgery in patients without a history of CAD and a Duke clinical score of <81. Conflict of interest: None. doi:10.1016/j.hlc.2010.04.032 32 POOR INITIATION AND PERSISTENCE WITH STATINS AFTER HOSPITALISATION FOR ACUTE ISCHAEMIC HEART DISEASE EPISODES IS COM- MON, PARTICULARLY IN PATIENTS NOT ADMITTED ON STATINS AJ Kerr 1,2,* , SJ Thornley 2 , W Chan 1 , R Jackson 2 1 Counties Manukau District Health Board, South Auckland, New Zealand 2 School of Population Health, The University of Auckland, Auckland, New Zealand Background: Long term use of HMGCo-A reductase inhibitors (statins) prolongs life and reduces recurrent events in people with ischaemic heart disease (IHD).