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Funding Acknowledgements Study No. 2.1/I/17, Sadowski, K. MD Background. Hypertrophic cardiomyopathy (HCM) is an hereditary disease in which the heart muscle becomes abnormally thick, which makes it harder for the heart to pump blood. Some people with HCM experience medical complications, including heart failure or sudden cardiac death (SCD). Due to lack of efficient causal treatment, the goal of HCM treatment is to relieve symptoms, slow down disease development and prevent SCD. For many years one of the major lifestyle recommendations for HCM patients was to refrain from excessive physical activity and stressful situations. At the same time, there is multiple scientific evidence that cardiac rehabilitation and regular physical activity can be beneficial in terms of treatment outcome and survival in cardiac patients. Nevertheless, data on adjustment and physical activity among HCM patients are scarce. Purpose. The presented study is a part of research on the effectiveness and safety of cardiac rehabilitation in HCM patients. This part aims to assess illness perception and adjustment to treatment among patients with HCM. Method. The study is an experimental randomized control trial (RCT). In part related to adjustment and mental health there are quantitative and qualitative measures used: questionnaires related to general health, illness perception, level of stress, adherence to treatment, and semi-structured interviews performed to assess patients’ concerns regarding illness identity, the impact of HCM on everyday life, and expectations of themselves and the medical team. The entire study population consists of 60 participants with HCM (cardiac rehabilitation/telerehabilitation vs usual care). Quantitative data will be analysed using appropriate tests (e.g. t-Student, regression analysis) and qualitative data will be analysed using Interpretative Phenomenological Analysis. Results. Preliminary results evaluate adjustment to treatment based on patients" experience and illness perception. The group for the qualitative study consists of 20 participants (M = 51,70; SD = 11,07; 13 F/ 5 M). Starting the treatment often led to intense distress because 70% of them have been diagnosed accidentally (20% after diagnosis or death of a family member). 20% of participants describe HCM using negative terms, and patients’ identity of HCM fall along a continuum from "curse"/"nightmare" to "value"/"relief". Patients’ adjustment is influenced the most by "being a role model for relatives struggling with HCM" and „adapting to barriers", and the most important expectation toward medical professionals was to be "approachable" and „attentive", which strenghtened the sense of security in threatening medical situations. Conclusions. Although many patients identify HCM as a burden, their adjustment to illness is mostly related to their need for being a positive role model for relatives with HCM. A therapeutic alliance with the medical team and experiencing kindness were the most important for the sense of security and being well treated.

Inflammation, high sympathetic tone, electrolyte changes and chronic kidney disease (CKD) are among the risk factors of postoperative atrial fibrillation (AF).(1) Studies show that elevated C-reactive protein levels may predict recurrent atrial arrhythmias (2) We present a case of a 70-year-old woman with paroxysmal atrial fibrillation who developed systemic inflammatory response syndrome and underwent unsuccessful electrical cardioversion of AF after pacemaker implantation.A 70-year-old woman diagnosed with symptomatic tachycardia-bradycardia syndrome, paroxysmal AF, chronic heart failure (NYHA II), hypertension, chronic kidney disease, after laparoscopic adrenalectomy due to Cushing syndrome, after mastectomy due to breast cancer was referred to the Department of Arrhythmias, Institute of Cardiology, Warsaw for pacemaker implantation. Physical examination revealed good general condition, lower limb edema and vaginal erythematous skin lesions corresponding to the clinical manifestation of candidiasis. Sinus rhythm with a heart rate of 62 beats per minute (bpm) was observed on ECG. At entry, laboratory investigations showed: white blood count (WBC)1071 cells/mm3; C-reactive protein 0.55 mg/dl; creatinine 1.4 ml/ min/1.73 m2; urea 79.4 mg/dl. Urine tests were performed at admission, showing no abnormalities. The patient underwent dual chamber pacemaker (DDD) implantation preceded by 1.5 g cefuroxime infusion. In the early post-implantation period AF with a high ventricular rate (150 bpm) was observed. Electrical cardioversion was performed to restore sinus rhythm. In 3 hours after successful intervention, sinus

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology. Background Hypertrophic cardiomyopathy (HCM) is a congenital heart disease influencing patients' physical capacity and quality of life and increasing the risk of sudden cardiac death. For many years patients with HCM were advised to avoid physical activity and intense psychological stress. Current studies suggest that cardiac rehabilitation (CR) could be safe and beneficial for somatic and psychological status in HCM patients. Method In the RCT study assessing the efficacy of hybrid CR patients with HCM from rehabilitation (R) and control (C) groups were asked to fill the questionnaires regarding their psychosocial well-being (GHQ-28) and illness perception (Brief IPQ) at every stage of the study (baseline, 3, 6, 9, and 15 months). Results There was a significant improvement in the overall distress level in the R group (p=0,003), but not in the C group (p=0.559). There were no significant differences in the illness perception (p=0.200 for the R group and p=0.090 for the C group), although the R group showed significant short-term improvement after three months (p=0.032). Conclusions Cardiac rehabilitation can enhance the psychological well-being of HCM patients and their adjustment to illness. However, significant improvement is observed only in the first months after the rehabilitation.