S32 Oral Presentations / International Journal of Cardiology 140, Supplement 1 (2010) S1–S93 ECG recordings (SDNN); the standart deviation of all 5-minute RR interval means in milliseconds (SDANN), root mean-square differences between consecutive RR intervals of the entire recording in milliseconds (rMSSD); the percentage of differences between adjacent filtered RR intervals that are greater than 50 ms for the whole analysis (pNN50). A standart 12-lead ECG was recorded with a paper speed of 25mm/s. The difference between the maximum and minimum QT intervals on any standart 1lead ECG was calculated as QT dispersion. Results: Basal clinical, hematologic and biochemical characteristics were similar between groups. LV diastolic function and LVEF were detected similar in both groups. The rhythm was sinus and there was no conduction abnormality in all subjects. Mean values of HRV parameters are listed. With respect to time domain indexes, SDNN, pNN50 and rMSSD values were significantly decreased in patients with BD. There was no statistical difference between the mean QT values of the patient and control groups however, QT dispersion parameters in the Behcet’s patients were longer than in controls. Conclusions: The reason for the attenuated HRV and impaired QT disper- sion in patients with BD is not clear. The most probable underlying basis is believed to be vasculitis, which involves multiple systems. OP-111 RELATIONSHIP BETWEEN CIRCADIAN BLOOD PRESSURE PATTERN AND QT DYNAMICITY IN PATIENTS WITH ARTERIAL HYPERTENSION Sercan Okutucu , Giray Kabakci, Hakan Aksoy, Cingiz Sabanov, Naresh Maharjan, Kenan Muhtarov, Banu Evranos, Ugur Karakulak, Kudret Aytemir, Lale Tokgozoglu, Hilmi Ozkutlu, Ali Oto Department of Cardiology, Hacettepe University, Ankara, Turkey Objective: Arterial blood pressure (ABP) follows a circadian type rhythm. Most of the people present a decline in ABP between 10- 20% during night-time intervals, which is called dipper pattern. It has been reported that the lack of nocturnal BP fall which is called, non-dipping is associated with more serious end organ damages when compared to hypertensives with dipping pattern. Abnormal QT dynamicity, which means abnormal rate adaptation of ventricular repolarization, is an important predictor of myocardial vulnerability. The aim of the present study was to evaluate QT dynamicity in hypertensive individuals with either non-dipper or dipper type circadian rhythm of BP. Methods: The study population included 44 individuals with newly diagnosed hypertension. All patients underwent 24-h ambulatory BP monitorization (ABPM), ambulatory ECG monitorization and transthoracic echocardiographic examination (TTE). Patients with history of cardiovas- cular, cerebrovascular or other systemic disease were excluded. Patients were accepted as hypertensive if the following were present: (i) current use of antihypertensive drugs; (ii) presence of resting systolic BP of 140 mmHg and/or diastolic BP of 90 mmHg; (iii) an average 24h blood pressure value above 130/80 mmHg. Patients with a decline in mean night time blood pressure of less than 10% were accepted as non dippers. Electrocar- diographic data were obtained with a three channel analog recorder (ELA Medical Limited) and analyzed with ELATEC holter software. All 24 hour periods were used to investigate QT dynamicity. Results: The dipper (n=22) and non-dipper (n=22) groups of hypertensive cases were similar for age (45.8±4.0 vs. 46.5±4.5 years), gender distri- bution ([male/female] 11/11 vs. 10/12), smoking status (32 vs. 32%), BHR (73.3±11.2 vs. 72.5±10.7 beats/minute), LVEF (63.7±2.8 vs. 64.3±2.5%) and AvSBP (135.1±3.0 vs. 137.2±5.0 mmHg), respectively. QT/RR slopes were significantly higher in non-dipper group (QTapex/RR=0.19±0.02 vs. 0.13±0.02, p=0.001; QTend/RR=0.18±0.02 vs. 0.15±0.02, p=0.001). Pear- son’s correlation analyses revealed a negative correlation between degree of night-time dipping and QT/RR slopes (QTapex/RR, r=-0.682, p=0.001; QTend/RR, r=-0.580, p=0.001). Conclusions: When compared with dippers, QT dynamicity is unfavorably altered in hypertensive patients with blunting of the nocturnal fall in BP. If the prognostic significance of QT dynamicity is considered, hyper- tensives with non-dipping pattern should be followed closely for adverse cardiovascular outcomes. OP-112 TRANSTHORACIC EPICARDIAL ABLATION IN THE TREATMENT RESISTANT LEFT POSTERIOR ACCESSORY PATHWAY Kutsi Kabul 1 , Nusret Acikgoz 2 , Baris Bugan 1 , Basri Amasyali 1 , Sedat Kose 1 , Turgay Celik 1 , Atila Iyisoy 1 , Hurkan Kursaklioglu 1 1 Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey 2 Inonu University, Department of Cardiology, Malatya, Turkey Objective: Endocardial radiofrequency catheter ablation of accessory path- way (AP) is the method of choice for the treatment of patients with Wolff-Parkinson-White (WPW) syndrome. The majority of the patients can successfully be treated by this procedure. The epicardial catheter ablation treatment is recommended in cases who have failed standard endocardial ablation approaches. Transthoracic epicardial ablation (TEA) has been rarely reported for cases with WPW syndrome in the literature. We present a successful case of TEA of a left posterior AP in the pericardial space. Methods: A 34-year-old man with recurrent palpitations and syncope attacs due to WPW syndrome was referred for radiofrequency catheter ablation whom had failed to previous repeated ablation attempts at other institutions. The 12-lead electrocardiogram, echocardiography, electrophys- iological study, and endocardial catheter ablation were performed to the patient. Results: The 12-lead electrocardiogram in sinus rhythm showed manifest AP. Clinical evaluation was normal. Echocardiography revealed normal structure and function. Catheters were inserted through the femoral vein and arterial to the high right atrium, coronary sinus, and right ventricular apex. Earliest endocardial ventricular activation during sinus rhythm was posterior the mitral annuli. A rapid orthodromic atrioventricular reentrant tachycardia and preexcited atrial fibrillation was induced with programmed electrical stimulation. After induced of preexcited atrial fibrillation because of deterioration hemodynamic changes in patient was done electrical car- dioversion. After failed conventional ablation procedures passed through TEA. Transthoracic puncture was performed below the xiphoid process that was performed under general anesthesia. A guidewire was placed into the epicardial space with fluoroscopy guidance. A 8 Fr sheath was advanced over the wire for mapping and ablation. Radiofrequency energy where the earliest ventricular activity on the surface pericardial was given. AP conduction was abolished and tachycardia could no longer be induced despite aggressive atrial and ventricular stimulation protocols. After the procedure complication was not seen, and the 12-lead electrocardiogram was normal. The patient discharged the next day. Conclusions: Due to the risk of TEA, performing it seems to be rational for the patients with high-risk for sudden death and symptomatic WPW. TEA should be the alternative solution to open surgical procedures in such patients. OP-113 IS CIRCUMFERENTIAL PULMONARY VEIN ABLATION EFFECTIVE IN PATIENTS WITH ATRIAL FIBRILLATION WHO HAD STRUCTURAL HEART DISEASE? Baris Bugan 1 , Turgay Celik 1 , Atila Iyisoy 1 , Kutsi Kabul 1 , Murat Celik 1 , Uygar Cagdas Yuksel 2 , Hurkan Kursaklioglu 1 , Sedat Kose 1 1 Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey 2 Sarikamis Army Hospital, Department of Cardiology, Sarikamis, Kars, Turkey Objective: Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity and mortality. Medical therapy remains suboptimal, with significant side effects and toxicities, and a high recurrence rate. So the physicians have been tended to perform percutaneous procedures. We aimed to present our long-term results of circumferential pulmonary vein ablation (CPVA) with electroanatomic mapping in patients who have structural heart disease with symptomatic AF. Methods: A total of 70 patients who had symptomatic AF, refractory to at least 2 anti-arrhythmic drugs with a mean age of 55±14 (21-75) years were included in the study. Fifty patients had paroxysmal AF, and twenty patients had non-paroxysmal AF (persistant AF; 12 patients, and permanent AF; 8 patients). The mean period of AF was 4.5±2.5 years. Totally, 24 patients (34%) had structural heart disease. The mean left ventricular EF and left atrial diameter were 50±5%, and 46±5 mm, in respectively. Ablation was guided by an 3D electroanatomical mapping