P478Early repolarization pattern in patients with structural heart disease: can it really predict sudden cardiac death?

Funding Acknowledgements: Grant from the Spanish Society of Cardiology Introduction: Identifying patients at risk for sudden cardiac death (SCD) remains a challenge. Early repolarization pattern in the inferolateral leads (ERP) has been associated with an increased risk of sudden cardiac death in patients without structural heart disease (SHD). We sought to determine its prognostic value in those with SHD. Methods: Patients with SHD to whom an implantable cardioverter defibrillator (ICD) was implanted in primary prevention from 2004 to 2015 were included. We determined the presence of ERP and other electrocardiographic (ECG) parameters. The primary endpoint was the occurrence of SCD or ventricular arrythmias (VA) requiring ICD therapies. Results: A total of 104 patients (mean age of 57±15 years, 85% men) were included. Forty-two percent had ischemic cardiomyopathy. A mean of 8.1±5.5 ECG were analyzed in every patient, finding ERP in 28.8%. During a mean follow-up of 3.9±2.5 years, 30% of patients presented the primary endpoint. The proportion of patients with ERP was not different in patients who presented the primary endpoint compared to those who did not: 29.7% vs 26.7%, respectively (p=0.76). Left ventricular ejection fraction, ventricular extrasystoles and atrial fibrillation at follow-up were independently associated to the primary endpoint (p<0.05). Conclusions: In our study, the presence of ERP in patients with SHD and an ICD implanted in primary prevention did not predict VA neither SCD.