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Funding Acknowledgements Type of funding sources: None. Introduction Antazoline (ANT) is an old antihistaminic medication with antiarrhythmic properties. After intravenous administration ANT exerts rapid antiarrhythmic effect often resulting in conversion of persistent atrial fibrillation (AF) to sinus rhythm (SR). However, published data on its effectiveness, safety and  clinical utility for rapid AF termination are limited and ANT is not recognized as a cardioversion drug.  Aim To assess the real-world efficacy of ANT for pharmacological cardioversion of paroxysmal and persistent non-valvular AF.  Methods We conducted a single center, retrospective, observational study including patients (pts) with history paroxysmal or persistent AF episode lasting less than 6 months, in stable cardiopulmonary condition who were qualified for elective pharmacological cardioversion with intravenous ANT. The primary end-point was the conversion of AF to SR confirmed in electrocardiography (ECG) during the 6-hours observation.  Results A total of 176 pts (mean age 68.4 ± 12.0 years, 49% male) were enrolled into the study. In 93 patients (52%) AF duration was shorter than 48 hours and median AF duration time was 24 (7 – 432) hours. The overall success rate of pharmacological cardioversion of AF with intravenous ANT was 45.5% (80/176 pts). The mean used dose of ANT was 250.9 ± 65.4mg. The subgroup analysis, regarding the AF duration, suggested the effectiveness of ANT mainly in in short-lasting AF (effectiveness of antazoline based cardioversion for AF lasting <48h vs others:  75.3% vs 12.0%,  p < 0.001). In multivariable logistic regression model AF duration (for every 24h in AF - OR = 0.97; 95% CI 0.96 – 0.98), the left atrium antero-posterior diameter (OR = 0.92; 95% CI 0.86 – 0.99) and the serum creatinine level (OR = 0.15; 95% CI 0.03 – 0.73) were identified as  independent predictors of antazoline based pharmacological cardioversion effectiveness, even after adjustment for comorbidities. The ROC curves revealed that the optimal cut-off value for AF duration time predicting ANT’s effectiveness was 48h (AUC = 0.876; 95% CI 0.815 – 0.922). There were only one episode of bradycardia <45 bpm related to ANT administration.  Conclusions Intravenous antazoline administration is effective and safe in rapid pharmacological cardioversion of paroxysmal AF, especially in the short-lasting AF (<48 hours) and in patients without the left atrium enlargement and significant renal disease. Abstract Figure.

Purpose The aim of this study is to assess the level of knowledge of safety and awareness about daily living in patients with cardiac implantable electronic devices (CIED) and potential impact upon anxiety and depression. Methods Data were collected in consecutive patients visiting pacemaker clinic for regular CIED follow-up. Demographic, clinical and psychological data were collected: Hospital Anxiety and Depression Scale-Modified (HADS-M) and a custom self-reported questionnaire was used (CIED-SRQ, 18 questions regarding daily activities, medical procedures and the safe use of electronic devices) to assess the knowledge regarding CIED. Dedicated questions referred to the preferences for CIED education channels in various age groups. Results We studied 186 patients (36,6% women, mean age 66,7±10,8) with CIED (63,5% pacemaker, 17,7% cardioverter defibrillator, 18,8% cardiac resynchronization therapy) in their first year following the implantation. In the CIED-SRQ the mean score of correct answers related to knowledge of CIED 13,25±2,86 (with 18 as the maximum possible score). The knowledge of CIED was correlated with the patients' level of education (p<0,001) and inversely correlated with age (rho=−0443; p<001). In the anxiety subscale of HADS-M, normal scores were noted in 75,8% patients, 13,5% cases were borderline, and abnormalities were observed in 10,7% patients. In the depression subscale, 70,4% were recognized as normal, 21,5% as borderline, and 8,1% as abnormal. As the knowledge of patients about CIED increased, there was a significant decrease in their depression level (rho=−0,149; p=0,042) and in the anxiety level (rho=−0,193; p=0,008). Anxiety level was higher in patients with CIED experiencing complications from the implantation (15,6% of patients in total experienced complications), both the mild (hematoma, bruising) and the severe (tamponade, lead dislocation, pneumothorax), when compared to the group without complications (p<0,001). Conversely, no statistically significant difference between these groups was found as to their level of depression (p=0,051). The younger patients (≤64 years) were more often in favour of remote education on CIED (p=0,025), while the elder (≥65 years) most often preferred to be personally informed by the attending physician. Conclusions Lack of information and misinformation in patients with CIED may result in self-imposed restrictions, which could in turn result in higher levels of anxiety and depression. Patients experiencing CIED complications should be offered increased psychological care as well as more intense education about CIED, due to higher anxiety levels. Age influences the preferences for CIED education channels, thus educational approach must be individualized and age-appropriate. These findings may help health care professionals to provide holistic care to help patients manage to live with CIED and optimize postprocedural quality of life. Funding Acknowledgement Type of funding sources: None.