Prevalence of atrial fibrillation on a 24-hour Holter in adult Indians.

OBJECTIVE: To evaluate paroxysmal atrial fibrillation (AF) prevalence in Indian adults who completed 24-Hour Holter monitoring. METHODS: A total of 23,847 patients (36.9 % women) were analyzed for AF duration using a software algorithm. RESULTS: AF was diagnosed in 4153 (17.4 %) patients with a median AF duration of 13 min and 55 s. CONCLUSION: AF prevalence was high and largely untreated. The short duration of AF episodes indicates a low likelihood of detection during clinical visits, highlighting its potential underestimation in Indian healthcare.

A Novel Treatment for Malignant Cough Syncope.

Cough Syncope, a form of Neurocardiogenic Syncope, occurs immediately after coughing due to to arterial baroreflex-mediated vasodilatation. Cough syncope has been classically described in patients with obstructive pulmonary diseases. Pulmonary Vascular Diseases, though rare, also present with cough syncope. Malignant Syncope is defined as recurrent syncope with minimal warning, and often associated with self-injury. Here we describe how we managed a case of a young male presenting with recurrent attacks of Malignant Cough syncope.

Mycobacterium abscessus causing native valve endocarditis due to peripherally inserted central catheter line.

Infections due to rapidly-growing mycobacteria (RGM) are increasing worldwide, especially in immunocompromised hosts. However, data on the clinical features of patients with RGM bacteremia are limited [1]. Data on the incidence of clinically significant non-tuberculous mycobacteria (NTM) infections from India are scarce as these are frequently under-diagnosed due to either under recognition by clinicians because of the nonspecific nature of their clinical manifestations, and/or the inadequacy of laboratory services [2].We present a case of Mycobacterium abscessus native tricuspid valve endocarditis in a patient who had a peripherally inserted central catheter line (PICC). Clinicians need to be aware of RGM as a cause of prolonged fever in patients who have chronic indwelling intravenous catheters [3].

BEAT Survey: A Cross-sectional Study of Resting Heart Rate in Young (18-55 Year) Hypertensive Patients.

BACKGROUND: Studies in Caucasian population have shown that sustained elevation of heart rate (HR) is associated with increased cardiovascular mortality and morbidity in patients with heart failure (HF), myocardial infarction (MI). However, resting HR is not so well-studied in Indian hypertensive patients. MATERIALS AND METHODS: BEAT is a cross-sectional survey to evaluate the resting HR in young (18-55 years) patients in India. Also study aims to correlate it with age, BP and body mass index (BMI) along with smoking habit and past medical history like coronary artery disease. RESULTS: A total of 3743 patients (mean age 45.69 ± 6.86 years; males 66.52%) were enrolled in study. Of them, 886 (23.67%) were diabetic, 712 (19.02%) had history of coronary artery disease and 818 (21.85%) had history of ever smoking.The average BMI was 26.15 (3.92) with majority of patients falling in either obese (19.85%) or overweight (53.42%) category. The average resting HR and BP were 82.79 ± 10.41 bpm and 146.82 ± 15.46/ 89.08 ± 8.8 mmHg. HR was found to have correlation with SBP (r = 0.247, p < 0.01), DBP (r = 0.219, p < 0.01); to lower extent with BMI (r = 0.041, p < 0.05); but not with age (r = -0.012, NS). CONCLUSION: The resting HR is elevated in the Indian hypertensive patients. It was found to have correlation with BP and to lesser extent with BMI, whereas there was no correlation with age. The chronically elevated HR even in patients under treatment may have implication on cardiovascular mortality and morbidity.