CRT53: STRATIFICATION OF ARRHYTHMIC RISK IN PATIENTS ELIGIBLE FOR CRT: COULD THE EMPLOYMENT OF BNP AND TWA BE USEFUL?

Aim of the study is to evaluate if BNP and TWA can better identify, in patients needing CRT, those who must receive ICD. Eight pts. suffering for refractory CHF were evaluated (NYHA III-IV, ischaemic or idiopathic DCM, average EF=22%, with inter/intraventricular asyncronisms). BNP was measured before, 3 and every six months after implantation. Five patients underwent TWA analysis, with a positive result. All pts. received ICD plus CRT. All pts. underwent: clinical and echocardiographyc evaluation, device controls, BNP and HRV analysis. Results all pts. improved their functional class, EF, BNP (reduced) and HRV (increased) due to the favourable effect of CRT. Nowadays (average follow-up: 8 months) no malignant arrhythmias conditioning ICD discharges occurred. Conclusions CRT significantly improves symptoms and haemodinamyc conditions in severe CHF. The dramatic reduction of basal BNP values well correlates with haemodinamyc restoration. The shortness of follow-up doesn't allow, at the moment, to foresee a relation between arrhythmic risk and BNP and basal TWA. Nevertheless we hope that the data of follow-up can support the property of a more selective stratification of the arrhythmic risk (and consequently of ICD implantation) based not only on EF.