Prevalence of Brugada electrocardiographic pattern in adult population - A community-based study from Kerala, South India.

There is no data for Brugada electrocardiographic pattern (BrEP) from India. In a cross-sectional study of men and women between the ages 20-79 years, electrocardiograms were analyzed following the 2002 consensus. The overall prevalence of BrEP was 1.

A community-based study on electrocardiographic abnormalities of adult population from South India - Findings from a cross sectional survey.

Background: There are no data on electrocardiographic (ECG) findings from general population of Indian subcontinent. We analyzed ECG abnormalities of in adults as part of a community survey of prevalence of coronary artery disease and risk factors from South India.

Methods And Results: In this cross-sectional study of men and women between the ages 20 to 79 years, ECGs recorded digitally were analyzed using the Minnesota code.

Prevalence, Awareness, Treatment, and Control of Hypertension in Young Adults (20-39 Years) in Kerala, South India.

Objective: We sought to study the prevalence of hypertension and the levels of awareness, treatment and control of hypertension in the young adults in Kerala, India compared to older adults.

Methods: We identified 1,221 young adults (men 36.7%) in the age group 20-39 years from the 5,150 participants of the Cardiological Society of India Kerala Coronary artery disease (CAD) and its Risk factors Prevalence (CSI Kerala CRP) Study.

Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Background: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain.

Methods: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest.

Microeconomic Costs, Insurance, and Catastrophic Health Spending Among Patients With Acute Myocardial Infarction in India: Substudy of a Randomized Clinical Trial.

Importance: Ischemic heart disease is the leading cause of death in India, and treatment can be costly.

Objective: To evaluate individual- and household-level costs and impoverishing effects of acute myocardial infarction among patients in Kerala, India.

Design, Setting, And Participants: This investigation was a prespecified substudy of the Acute Coronary Syndrome Quality Improvement in Kerala study, a stepped-wedge, cluster randomized clinical trial conducted between November 2014 and November 2016 across 63 hospitals in Kerala, India.

Prevalence and One-year Outcome of Carotid Sinus Hypersensitivity in Unexplained Syncope: A Prospective Cohort Study from South India.

Background: Carotid sinus syndrome accounts for one third of patients who presents with unexplained syncope. Prevalence of carotid sinus hypersensitivity (CSH) in Indians has not been studied till now.

Objectives: To assess the prevalence and associations of CSH in symptomatic patients above 50 years and to study its prognostic significance pertaining to sudden cardiac death, syncope, recurrent pre syncope and falls on 1 year follow up.

Health-Related Quality of Life at 30 Days Among Indian Patients With Acute Myocardial Infarction.

Background: Despite a high cardiovascular disease burden, data on patient-reported health status outcomes among individuals with cardiovascular disease in India are limited.

Methods And Results: Between November 2014 and November 2016, we collected health-related quality of life data among 1261 participants in the ACS QUIK trial (Acute Coronary Syndrome Quality Improvement in Kerala). We used a translated, validated version of the Seattle Angina Questionnaire administered 30 days after discharge for acute myocardial infarction, wherein higher scores represent better health status.

Prevalence of peripheral artery disease and risk factors in the elderly: A community based cross-sectional study from northern Kerala, India.

Background And Objective: There are no data on the prevalence of peripheral artery disease (PAD) and risk factors in Indians. This study was aimed at studying the prevalence of PAD and risk factors in elderly population of northern parts of Kerala, South India.

Methods: In a prospective observational survey we evaluated men and women of age between 60 and 79 years from Kerala.

Effect of a Quality Improvement Intervention on Clinical Outcomes in Patients in India With Acute Myocardial Infarction: The ACS QUIK Randomized Clinical Trial.

Importance: Wide heterogeneity exists in acute myocardial infarction treatment and outcomes in India.

Objective: To evaluate the effect of a locally adapted quality improvement tool kit on clinical outcomes and process measures in Kerala, a southern Indian state.

Design, Setting, And Participants: Cluster randomized, stepped-wedge clinical trial conducted between November 10, 2014, and November 9, 2016, in 63 hospitals in Kerala, India, with a last date of follow-up of December 31, 2016.

Prevalence and prognostic significance of left ventricular myocardial late gadolinium enhancement in severe aortic stenosis.

Background: Myocardial fibrosis occurs in aortic stenosis (AS) as part of the hypertrophic response. It can be detected by LGE, which is associated with an adverse prognosis in the form of increased mortality and morbidity.

Objectives: To assess the prevalence of LGE patterns using cardiac magnetic resonance (CMR) in severe AS patients and to study its prognostic significance.

Demographical and clinicopathological characteristics in heart failure and outcome predictors: a prospective, observational study.

Aims: The aims of the study were to study the demographical and clinicopathological characteristics of patients presenting with heart failure and evaluate the 1 year outcomes and to identify risk predictors if any.

Methods And Results: A prospective observational study was conducted in consecutive patients of systolic heart failure. The study was divided into two parts-an initial 6 month enrolment phase followed up for 1 year for major adverse cardiovascular events.

Safety and efficacy of percutaneous balloon mitral valvotomy in severe mitral stenosis with moderate mitral regurgitation - A prospective study.

Background: Percutaneous balloon mitral valvotomy (PBMV) is generally considered as a contraindication in patients with mitral stenosis (MS) associated with moderate to severe mitral regurgitation (MR). We sought to compare the safety and efficacy of PBMV in patients with severe MS and with moderate MR with those with less than moderate or no MR.

Materials And Methods: Symptomatic patients of MS with mitral valve area ≤1.

Maternal and fetal outcomes in pregnant women undergoing balloon mitral valvotomy for rheumatic mitral stenosis.

Background: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy.

Methods And Results: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed.

Mean platelet volume and cardiovascular outcomes in acute myocardial infarction.

Objective: High levels of mean platelet volume (MPV) may be associated with adverse outcomes in patients with myocardial infarction (MI). We examined the association between MPV and the risk of death and adverse cardiovascular outcomes in patients with MI.

Methods: We studied consecutive patients with MI admitted to a tertiary-care hospital during a period of 1 year.

A comparative study of ivabradine and atenolol in patients with moderate mitral stenosis in sinus rhythm.

Background: Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to examine whether ivabradine was superior to atenolol for achieving higher exercise capacity in patients with moderate mitral stenosis in sinus rhythm. We also evaluated their effects on left ventricular myocardial performance index (MPI).

Device closure of pulmonary arteriovenous malformation using Amplatzer vascular plug II in hereditary hemorrhagic telangiectasia.

Pulmonary arteriovenous malformations (AVM) are very rare and carry the risk of cerebral thrombo-embolism, brain abscess or pulmonary hemorrhage. The Amplatzer vascular plug II (AVP II) is a new device, used for embolization of the pulmonary AVMs. We report a case of pulmonary AVM successfully managed by using AVP II in a patient with hereditary hemorrhagic telangiectasia (HHT).

'A twist in the heart' - Echocardiographic diagnosis of criss-cross heart.

Criss-cross heart is an extremely rare congenital anomaly seen in less than 0.1% of all congenital heart diseases. We present a case of criss-cross heart in a 13-year-old boy.

Malignant arrhythmia with benign tumour: fibrolipoma of the left ventricle.

We report a case of young male referred for evaluation of recent onset recurrent syncope. Inhospital electrocardiogram revealed an episode of ventricular flutter which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram showed hyperechoic mass in the left ventricle.

Hammock mitral valve: a rare cause of congenital mitral regurgitation--a case report.

Hammock valve, also known as anomalous mitral arcade is a rare mechanism for congenital mitral insufficiency. We report a case of a two-week-old neonate who presented with features of heart failure and an apical systolic murmur. Echocardiogram showed severe mitral regurgitation and abnormal mitral valve with direct attachment of mitral leaflets to papillary muscle without intervening chordae tendinae, typical of hammock valve.

Optimal in-hospital and discharge medical therapy in acute coronary syndromes in Kerala: results from the Kerala acute coronary syndrome registry.

Background: In-hospital and postdischarge treatment rates for acute coronary syndrome (ACS) remain low in India. However, little is known about the prevalence and associations of the package of optimal ACS medical care in India. Our objective was to define the prevalence, associations, and impact of optimal in-hospital and discharge medical therapy in the Kerala ACS Registry of 25,718 admissions.

Presentation, management, and outcomes of 25 748 acute coronary syndrome admissions in Kerala, India: results from the Kerala ACS Registry.

Aims: There are limited contemporary data on the presentation, management, and outcomes of acute coronary syndrome (ACS) admissions in India. We aimed to develop a prospective registry to address treatment and health systems gaps in the management of ACSs in Kerala, India.

Methods And Results: We prospectively collected data on 25 748 consecutive ACS admissions from 2007 to 2009 in 125 hospitals in Kerala.