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19. PREVALENCE AND PREDICTORS OF COVID 19 RELATED BURNOUT AMONG HEALTHCARE WORKERS; FINDINGS FROM BRUCEE LI STUDY

Author

Gupta, Mohit Dayal, primary, Jha, Manish, additional, Girish, M.P., additional, Bansal, Ankit, additional, Sarkar, Prattay G., additional, Yusuf, Jamal, additional, Kumar, Suresh, additional, Kumar, Satish, additional, Jain, Ajeet, additional, Kathuria, Sanjeev, additional, Saijpaul, Rajni, additional, Yadav, Rakesh, additional, S, Ramakrishnan, additional, Malhotra, Rajeev, additional, Batra, Vishal, additional, Mukhopadhyay, Saibal, additional, Gupta, Anubha, additional, Shetty, Manu, additional, Mishra, Anurag, additional, Malhotra, Vikas, additional, and Garg, Sandeep, additional

Published
2021
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22. Design and rationale of an intelligent algorithm to detect BuRnoUt in HeaLthcare workers in COVID era using ECG and artificiaL intelligence: The BRUCEE-LI study

Author

Gupta, Mohit D., primary, Bansal, Ankit, additional, Sarkar, Prattay G., additional, Girish, M.P., additional, Jha, Manish, additional, Yusuf, Jamal, additional, Kumar, Suresh, additional, Kumar, Satish, additional, Jain, Ajeet, additional, Kathuria, Sanjeev, additional, Saijpaul, Rajni, additional, Mishra, Anurag, additional, Malhotra, Vikas, additional, Yadav, Rakesh, additional, Ramakrishanan, S., additional, Malhotra, Rajeev K., additional, Batra, Vishal, additional, Shetty, Manu Kumar, additional, Sharma, Nandini, additional, Mukhopadhyay, Saibal, additional, Garg, Sandeep, additional, and Gupta, Anubha, additional

Published
2021
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26. COVID 19-related burnout among healthcare workers in India and ECG based predictive machine learning model: Insights from the BRUCEE- Li study

Author

Gupta, Mohit D., Jha, Manish Kumar, Bansal, Ankit, Yadav, Rakesh, Ramakrishanan, Sivasubramanian, Girish, M.P., Sarkar, Prattay G., Qamar, Arman, Kumar, Suresh, Kumar, Satish, Jain, Ajeet, Saijpaul, Rajni, Gupta, Vandana, Kansal, Deepankar, Garg, Sandeep, Arora, Sameer, Biswas, P.S., Yusuf, Jamal, Malhotra, Rajeev K., Batra, Vishal, Kathuria, Sanjeev, Mehta, Vimal, Safal, Shetty, Manu Kumar, Mukhopadhyay, Saibal, Tyagi, Sanjay, and Gupta, Anubha

Abstract

COVID-19 pandemic has led to unprecedented increase in rates of stress and burn out among healthcare workers (HCWs). Heart rate variability (HRV) has been shown to be reflective of stress and burnout. The present study evaluated the prevalence of burnout and attempted to develop a HRV based predictive machine learning (ML) model to detect burnout among HCWs during COVID-19 pandemic.

Published
2021
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27. Left and right ventricular deformation in patients with severe mitral stenosis and pulmonary hypertension undergoing percutaneous balloon mitral valvuloplasty: A two dimensional speckle-tracking echocardiographic study

Author

Mahajan, Sudhanshu, Mehra, Pratishtha, Mehta, Vimal, Yusuf, Jamal, Safal, Gupta, Abhishek, Kathuria, Sanjeev, and Mukhopadhyay, Saibal

Abstract

Seventy-five patients with isolated severe MS (mitral valve area: 1.10 ± 0.15 cm2) and pulmonary hypertension underwent regional and global longitudinal strain (GLS) measurements of left (LV) and right ventricle (RV) at baseline and within 48 h after percutaneous balloon mitral valvuloplasty (PBMV). PBMV resulted in significant improvement in LV GLS (−16.35 ± 1.67% vs −19.98 ± 2.17%) and RV GLS (−10.34 ± 2.38% vs −13.83 ± 2.04%), p < 0.001 for both. Absolute increase in strain of basal segments of LV was more compared to mid and apical segments. We also found significant positive correlation between decrease in mean LA pressure (pre PBMV 28.91 ± 4.21 mm Hg vs post PBMV 10.55 ± 3.04 mm Hg, difference of 16.36 mm Hg; p < 0.001) obtained invasively during PBMV for 62 patients with improvement in LV GLS (r = 0.257, p = 0.048), RV GLS (r = 0.267, p = 0.043), and fall in right ventricular systolic pressure (r = 0.308, p = 0.022) that occurred post PBMV. The LV dysfunction is predominantly because of altered hemodynamics due to restricted LV filling with additional contribution from rheumatic involvement of basal LV myocardial segments. The improvement in LV deformation after PBMV is likely due to increase in preload. RV afterload reduction because of LA pressure decrease improved RV deformation.

Published
2020
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32. Left Atrial Function by Two-Dimensional Speckle Tracking Echocardiography in Patients with Severe Rheumatic Mitral Stenosis and Pulmonary Hypertension

Author

Mehta, Vimal, Chaudhari, Dhanjibhai, Mehra, Pratishtha, Mahajan, Sudhanshu, Yusuf, Jamal, Gupta, Mohit D., Kathuria, Sanjeev, Safal, D.M., Dabla, Pradeep Kumar, Sukhija, Rishi, and Mukhopadhyay, Saibal

Abstract

We studied left atrial (LA) function in severe rheumatic mitral stenosis (MS) patients using two-dimensional speckle tracking echocardiography (STE). Eighty patients with isolated severe MS in sinus rhythm and 40 controls underwent comprehensive echocardiography including STE derived LA strain [reservoir strain (LASr), conduit strain (LAScd) and contractile strain (LASct)]. The mean MVA was 0.93±0.21 cm2. The mean values of LASr(14.73±8.59%), LAScd(-7.61±4.47%) and LASct(-7.16±5.15%) in patients were significantly lower (p <0.001) vs. controls 44.11±10.44%, -32.45±7.63%, -11.85±6.77% respectively and showed decreasing trend with increasing MS severity and higher NYHA class. In conclusion, LA dysfunction is prevalent in severe MS irrespective of NYHA functional class.

Published
2021
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34. Fracture and plastering of distal left main stent during double-kissing Culotte technique: a case report.

Author

Mukhopadhyay S, Muheeb G, Yusuf J, and Kathuria S

Abstract

Background: Acute fracture of a left main (LM) stent during angioplasty is a rare complication. Cardiologists should be aware of the risk of stent fracture (SF) following kissing balloon inflation (KBI) even if the effective diameter of the balloons does not exceed the recommended expansion limits of stents., Case Summary: A 64-year-old female with hypertension and dyslipidaemia presented with crescendo angina since three months in spite of optimal medical therapy. Coronary angiogram showed a distal LM bifurcation lesion. The patient was admitted for LM bifurcation stenting by upfront two-stent technique (inverted double-kissing Culotte technique). Following first KBI of the stent placed from left circumflex artery (LCX) to LM, there was stent deformation in the LM shaft. As we had planned the Culotte technique, we decided to exclude the fractured segment by stenting from left anterior descending artery (LAD) to LM. The stent from LAD-LM successfully excluded the fractured part of the first stent from the lumen of LM. Optical coherence tomography done after final KBI from LCX-LM revealed successful exclusion of the deformed segment of the LCX stent with mild malapposition at the site of the deformed stent. A follow-up angiogram after six months showed normal in-stent flow with no evidence of restenosis or pseudoaneurysm., Discussion: Acute LM SF during coronary intervention can occur even if the effective cumulative diameter of the inflated balloons does not exceed the mentioned expansion limit of stents. Intravascular imaging is a helpful modality to define type of SF and its management., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2024
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35. Positive QRS complex in limb lead 2 with negative QRS in lead 3 on surface electrocardiogram: A novel predictor for anterior location of right-sided accessory pathways (10-1 o'clock on tricuspid annulus).

Author

Bera D, Mukherjee SS, Majumder S, Sikdar S, Dasgupta K, Kar A, Kathuria S, and Sarkar R

Subjects
Adolescent, Adult, Bundle of His, Electrocardiography, Female, Humans, Male, Middle Aged, Young Adult, Accessory Atrioventricular Bundle diagnosis, Accessory Atrioventricular Bundle surgery, Catheter Ablation, Pre-Excitation Syndromes surgery, Wolff-Parkinson-White Syndrome
Abstract

Background: Localization of atrioventricular accessory pathways (AP) from Electrocardiogram (ECG) is crucial for successful ablation. We analyzed the value of limb lead 2 versus 3 QRS vector discordance on surface ECG among right-sided pathways., Methods: Data from consecutive patients undergoing successful ablation of manifest AP were analyzed. They were categorized into two groups-Gr I: Endocardial ablation from anterior and anterolateral tricuspid annulus (TA, 10-1 o'clock, right anterolateral [RAL]); Gr II: Ablation outside this region (1-10 o'clock of TA). Inferior lead discordance (ILD) was defined as positive QRS complex (monophasic R, Rs) in lead 2 with negative/equiphasic QRS vector in lead 3 (rS, S, RS). Maximally pre-excited ECGs during electrophysiology study were compared for presence of ILD., Result: Among total 22 cases (Age 36 ± 18 years, 12 males), ILD was noted in 4/4 cases of Gr I. It was absent among 17/18 cases of right-sided AP in Gr II. The only case in Gr II having ILD was ablated near 8 o'clock (posterolateral). In contrast to the other four cases, aVF was negative, along with lead 3. A close differential was mid-septal AP (MSAP). However, the MSAP had absence of r in V1 and lead 2 having rS/RS complex in contrast to strongly positive QRS in RAL pathways. The sensitivity and specificity of ILD for RAL are 100% and 95%, respectively. The positive, negative predictive value, and accuracy are 80%, 100%, and 95%, respectively., Conclusion: Positive QRS complex in lead 2 with negative QRS in lead 3 in maximally pre-excited ECG is often predictive of anterior and anterolateral location among right-sided pathways., (© 2022 Wiley Periodicals LLC.)

Published
2022
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36. Left atrial function by two-dimensional speckle tracking echocardiography in patients with severe rheumatic mitral stenosis and pulmonary hypertension.

Author

Mehta V, Chaudhari D, Mehra P, Mahajan S, Yusuf J, Gupta MD, Kathuria S, Safal, Dabla PK, Sukhija R, and Mukhopadhyay S

Subjects
Atrial Function, Left, Echocardiography methods, Heart Atria diagnostic imaging, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Mitral Valve Stenosis diagnosis, Mitral Valve Stenosis diagnostic imaging
Abstract

We studied left atrial (LA) function in severe rheumatic mitral stenosis (MS) patients using two-dimensional speckle tracking echocardiography (STE). Eighty patients with isolated severe MS in sinus rhythm and 40 controls underwent comprehensive echocardiography including STE derived LA strain [reservoir strain (LAS r ), conduit strain (LAS cd ) and contractile strain (LAS ct )]. The mean MVA was 0.93 ± 0.21 cm 2 . The mean values of LAS r (14.73 ± 8.59%), LAS cd (-7.61 ± 4.47%) and LAS ct (-7.16 ± 5.15%) in patients were significantly lower (p < 0.001) vs. controls 44.11 ± 10.44%, -32.45 ± 7.63%, -11.85 ± 6.77% respectively and showed decreasing trend with increasing MS severity and higher NYHA class. In conclusion, LA dysfunction is prevalent in severe MS irrespective of NYHA functional class., Competing Interests: Declaration of competing interest All the authors declare that they have no conflicts of interest with respect to the present submission., (Copyright © 2021 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.)

Published
2022
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37. Riata lead failure manifests as electrical storm with lead parameters showing unique postural variations: a case report.

Author

Uppal A, Kathuria S, Shah B, and Trehan V

Abstract

Background: Riata implantable cardioverter-defibrillator (ICD) leads are prone to a unique type of mechanical lead failure causing conductor externalization (CE) which may be complicated by a delayed-onset electrical lead failure (ELF)., Case Summary: A 60-year-old male with symptomatic, severe ischaemic cardiomyopathy, and atrial fibrillation following a prior anterior wall myocardial infarction received a dual-chamber ICD with 7F-RiataST ventricular lead as a primary prevention strategy against sudden cardiac death in 2008. In 2017, a pulse generator replacement was performed for elective replacement indicator status. At that time, CE was noted in the ventricular lead but the electrical lead parameters were normal, hence lead replacement was decided against and the patient was closely followed up thereafter. Four years later, the patient presented with multiple ICD shocks within 48 h. Implantable cardioverter-defibrillator interrogation showed noise on the ventricular electrogram (EGM) channel that was detected as ventricular fibrillation (VF) episodes, triggering inappropriate ICD therapy (five ICD detected VF events within 24 h triggering three antitachycardia pacing therapies and one shock). Lead impedance and R-wave amplitude were within normal range in supine position but dramatically worsened in sitting posture. A new ventricular lead was implanted and the old lead abandoned. The patient has not experienced any device therapy in the follow-up period., Discussion: An electrically inert CE of Riata ICD leads needs close follow-up because an ELF may occur even after several years. A careful analysis of EGMs including postural changes in lead parameters can aid in detection and better characterization of underlying electrical dysfunction following CE., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2021
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38. Accuracy of 64-slice CT coronary angiography: our initial experience.

Author

Prakash A, Ahlawat K, Kaul UA, Tyagi S, Aggarwal B, Rajan S, and Kathuria S

Subjects
Adult, Aged, Aged, 80 and over, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Coronary Stenosis physiopathology, Female, Heart Rate, Hemodynamics, Humans, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Time Factors, Coronary Angiography, Coronary Stenosis diagnosis
Abstract

Objective: The objective of our study was to evaluate the diagnostic accuracy of 64-slice computed tomography coronary angiography to detect haemodynamically significant stenosis (>50% luminal narrowing) in comparison to invasive coronary angiography and further analyze the result accounting for heart rate, coronary calcification and location of lesion in the coronary tree., Methods and Results: Forty patients (39 male, 1 female; mean age 50.9 years) underwent both CT coronary angiography and invasive coronary angiography with in a gap of one day. All vessels were included in the study and no patient was excluded due to high heart rate. On per-segment based analysis with invasive coronary angiography as the gold standard, CT coronary angiography correctly identified 62 out of 78 significant stenoses with an overall sensitivity of 79.5% (62 of 78), specificity of 98.5% (532 of 540), positive predictive value of 88.6% (62 of 70) and negative predictive value of 97.1% (532 of 548)., Conclusion: Our result suggests that 64-slice CT coronary angiography has high diagnostic accuracy to detect haemodynamically significant stenosis.

Published
2008

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