associated with increased all-cause mortality (normal 6.8%, mild 4.6%, moderate 20.6%, and severe LA dilation 21.6%, P=0.001) and cardiac-related mortality rate (normal 4.1%, mild 4.6%, moderate 15.5%, and severe LA dilation 13.5%, P=0.009) in this cohort. Multivariable Cox proportional hazards regression analysis showed that LA enlargement remained an independent determinant for allcause mortality (adjusted Hazard ratio [HR] 1.80, 95% CI 1.23-2.61, P=0.002) and cardiac mortality (HR 1.68, 95%

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... I 1.11-2.54, P=0.015) after adjusted for age, gender, body mass index, NYHA class, atrial fibrillation, serum uric acid level. Conclusion: LA enlargement is an independent risk factor for long-term mortality in HFrEF patients treated with ICD. Introduction: Chronic total coronary occlusion (CTO) has been demonstrated to be an independent predictor of appropriate discharges for secondary prevention implantable cardioverter-defibrillators (ICD) patients with coronary artery disease. Objetive: To assess the prevalence of CTO for secondary prevention ICD patients with ischemic heart disease and its relation to the ejection fraction (EF). Methods: We retrospectively examined 1052 ICD patients from 1996 to 2016 in our hospital. A total of 456 had suffered from previous myocardial infarction and 263 were implanted for ventricular fibrillation, sustained ventricular tachycardia or syncope. We included in the study those patients with available coronariography prior to implantation. Results: We included 143 patients, 93% male, with a median age of 68 years (61-74). The prevalence of CTO was 54% (n=77); the right coronary artery was the most affected one (n=41, 53%), followed by the left anterior descending artery in 30% (n=23) and the circumflex artery in 17% (n=13). The median EF was 40% (30-47). Of the patients with OTC, 46 patients (60%) had EF equal or greater than 35%. With a median follow-up of 48 months (9-89), 39 patients (27%) had at least one appropriate discharge. Discharge-free survival was significantly lower in CTO patients (62% vs. 85%, Log Rank p=0.003). There were no statistically significant differences in the affected artery (Log Rank p=0.856). CTO (HR 2.46, 95% CI, 1.186-5.19 p=0.016) and EF (HR 0.962, 95% CI 0.935-0.991 p=0.01) were independent predictors of appropriate discharges according to multivariate analysis. Conclusions: For secondary prevention ischemic heart disease ICD patients, CTO is highly prevalent and is not often associated with severe ventricular dysfunction. CTO and decreased EF were predictors of arrhythmic events at followup.