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- 저자 : ( Harikrishna Tandri ) (검색결과 2 건)
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( Srinivasa Raghavan Madhavan ),( Harikrishna Tandri ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The mortality due to Coronary Artery Disease (CAD) in India is estimated to more than double from 13 million in the year 2000 to 30 million in 2015. Sudden cardiac death (SCD), defi ned as sudden unexpected death occurring within 1 hour of onset of symptoms, is a common initial manifestation of CAD. The primary objective of this study was to elicit the factors predicting mortality following Myocardial Infarction (MI), the secondary objective was to look at the incidence and factors predicting SCD. Methods: Patients with newly diagnosed MI, admitted to a tertiary care hospital in southern India, with no previous MI or cancer were eligible to participate. A case worker was assigned to each patient who contacted the patient every 3 months. Multivariate COX proportional hazard regression model was used to predict survival. Results: A total of 1027 participants were enrolled and followed for a mean 10.7(±7.45) months. Mean Age was 56(±12) years. During this period of time, 62 participants died and among those 26 deaths were adjudicated as SCD. While adjusting for other risk factors, age greater than 50 years, medication noncompliance and left ventricular ejection fraction (LVEF) < 30%, were signifi cant predictors of mortality (HR 3.48 (p 0.004), 14.32 (p <0.0001) and 2.58 (p 0.05) respectively). Conclusions: The overall one year mortality post MI in this rural south Indian population was around 6%, SCD accounted for more than half of the deaths. Medication noncompliance, age greater than 50 years and LVEF<30% were found to be good predictors of overall mortality. Follow up strategies, aimed at increasing compliance of patients in using medications post MI, would improve the mortality post MI.
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Epicardial Ablation of Ventricular Tachycardia: a Review
Rhanderson Cardoso,Arash Aryana,Sheldon M. Singh,Harikrishna Tandri,Andre d'Avila 대한심장학회 2018 Korean Circulation Journal Vol.48 No.9
For over 3 decades, it has been known that reentry circuits for ventricular tachycardia (VT) are not limited to the subendocardial myocardium. Rather, intramural or subepicardial substrates may also give rise to VT, particularly in those with non-ischemic cardiomyopathy. Percutaneous epicardial mapping and ablation has been successfully introduced for the treatment of such subepicardial VT. Herein, we review the indications for epicardial ablation and the identification of epicardial VT by electrocardiographic and imaging modalities. We also discuss the optimal technique for epicardial access and the implications of epicardial fat which has the potential to mimic scar, decreasing the specificity of electrogram morphology and impeding energy delivery to the tissue. Finally, we also report on possible complications of the procedure and strategies to mitigate adverse events.
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