Qualification: 
MD, DM, MBBS
navinmathew@aims.amrita.edu

Dr. Navin received his MBBS degree in 1996 from Calicut University after his training from Trichur Medical College. Subsequently, he got training from the Stanley Medical College, Chennai and received his MD (Internal Medicine) in 2001. He joined the prestigious All India Institute of Medical Sciences in December 2002 for his cardiology training and was awarded the Jagesh Lal Kapila medal for being the best post graduate in AIIMS cardiology 2005.

Since 2006, Dr. Navin is in the Department of Cardiology at the Amrita Institute of Medical Sciences and is a valuable member of the heart team.

Area of Interest (s)

  • Interventional Cardiology
  • Primary PTCA
  • Complex Coronary interventions
  • IVUS-intravascular ultrasound & OCT
  • Fractional flow reserve
  • Rotablation for calcified coronary lesions
  • Peripheral angioplasty and stenting including carotid, renal and iliofemoral
  • Complex aortic interventions
  • EVAR for aortic aneurysms and stenting for aortic dissections
  • Hybrid procedures for aneurysms involving the aortic arch
  • Percutaneous aortic valve replacement(TAVI)
  • Device closure of ASDs
  • Device closure of paravalvular leaks
  • Device closure of post myocardial infarction ventricular septal rupture
  • Coil closure of arteriovenous fistula
  • Device therapies
  • PPI , AICD , CRT
  • Clinical Cardiology & Cardiac Intensive Care
  • Lipidology
  • Echocardiography (Trans thoracic and trans esophageal)
  • Clinical Cardiac Research

Publications

Publication Type: Journal Article

Year of Publication Title

2019

M. Subramanian, Peravali, S., Dr. Hisham Ahamed, and Navin Mathew, “Arrhythmogenic right ventricular cardiomyopathy and sick sinus syndrome : a potential overlap syndrome”, European Heart Journal - Cardiovascular Imaging , vol. 20, Suppliment 2, p. ii53, 2019.[Abstract]


Introduction –

Abnormalities of desmosomes, more specifically mutations in the desmoplakin (DSP) gene, have been shown to cause not only arrhythmogenic right ventricular cardiomyopathy (ARVC) but also sick sinus syndrome (SSS) as well. Although various ARVC overlap syndromes have been described, its association with sinus node dysfunction is not documented. In this report, we describe an autosomal dominant missense mutation in the DSP gene in a proband with sick sinus syndrome and features of ARVC on cardiac MRI.

Clinical case –

A 70 year old man presented with a recurrent episodes of syncope, that were historically suggestive of an arrhythmic etiology. He had a history of systemic hypertension which was under adequate control with ACE inhibitors. His 2D Echocardiogram (ECHO) revealed a structurally normal heart. During his evaluation of syncope, his baseline electrocardiogram (ECG), head up tilt test, brain imaging, and electroencephalography were non-contributory. Cardiac MRI(CMR) examination was performed with 1.5-T MR Imager using a dedicated cardiac phase array coil. It revealed focal out-pouching in the right ventricular free wall that did not satisfy the major ARVD Task Force Criteria. The LV wall morphology and function was normal. No obvious late enhancement was noted. As extended 24 hour and 7 day ECG Holter monitoring also did not reveal any abnormalities, an implantable loop recorder was implanted. This revealed multiple sinus pauses (longest pause of 3.2 seconds) suggestive of sick sinus syndrome. The patient underwent a dual chamber implantable cardioverter defibrillator, and is doing well on follow up. In view of CMR findings suggestive of ARVC ,whole exome sequencing was done and it revealed a missense substitution affecting desmoplakin (DSP) gene on chromosome 6p24.3, previously described as ARVD8.

Family screening –

As shown in Figure 1, the entire family of the proband (I,1) was screened for both features of ARVD and sinus node dysfunction. All children of the proband were asymptomatic at the time of screening. An ECG, 2D ECHO, Exercise testing, CMR , as well as genetic screening was performed. All children were carriers for the same missense mutation (ARVD8) on the DSP gene. In one of the sons (II,1) of the proband, CMR revealed RV dilation and dyskinesia of the anterior right ventricular free wall, suggestive of ARVD. There were no features of sinus node dysfunction in any of the children of the proband.

Conclusion –

Autosomal dominant missense mutations on the desmoplakin (DSP) gene can cause a potential overlap syndrome of ARVC and sick sinus syndrome. Patients with this mutation are may be at higher risk for both cardiac conduction abnormalities and life-threatening ventricular arrhythmias, and hence both CMR and genetic screening are crucial in their risk stratification

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2016

M. Aggarwal, Vijan, V., Vupputuri, A., Nandakumar, S., and Navin Mathew, “A Rare Case of Fatal Endocarditis and sepsis caused by Pseudomonas aeruginoda in a patient with chronic renal failure”, JCDR, vol. 10, 2016.

2016

M. Aggarwal, Vijan, V., Vupputuri, A., Nandakumar, S., and Navin Mathew, “A rare case of fatal endocarditis and sepsis caused by Pseudomonas aeruginosa in a patient with chronic renal failure”, Journal of Clinical and Diagnostic Research, vol. 10, pp. OD12-OD13, 2016.[Abstract]


Nosocomial catheter-related and Arteriovenous fistula (AV)-related infections are significant concern in patients undergoing haemodialysis. These infections are associated with multiple complications as well as mortality and demands immediate and appropriate management. While coagulase-negative staphylococci, S.aureus, and Escherichia coli are the most common causes of catheter-related infections in haemodialysis patients, such infections caused by Pseudomonas aeruginosa are relatively rare. Here, we present an unusual case of 36-year-old male patient with chronic renal failure, who developed endocarditis and sepsis from Pseudomonas aeruginosa infection of the left hand arteriovenous fistula. The bacteraemia in the present case caused multiple complications including dry gangrene of bilateral lower limbs, stroke, endophthalmitis, left brachial artery thrombosis and vegetations on the interventricular septum and aortic wall. Despite antibiotic treatment, the patient suffered a cardiac arrest and could not be revived. More »»

2013

K. Tummala, Maniyal, V. K., Chandrashekaran, R., Navin Mathew, and Ganeshwala, G., “Cardiac anaphylaxis: a case of acute ST-segment elevation myocardial infarction after IM epinephrine for anaphylactic shock.”, The American journal of emergency medicine, vol. 31, pp. 1157.e1-3, 2013.[Abstract]


A 62-year-old male smoker with no other comorbidities presented to emergency department with systemic anaphylaxis, due to oral diclofenac for toothache. He developed acute anterior wall myocardial infarction following IM epinephrine 1 mg 1:1000. Primary percutaneous coronary intervention was done, which showed a thrombus in the mid left anterior descending artery with no evidence of obstructive coronary artery disease after thrombus aspiration.

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