Dr. Saritha Sekhar S. currently serves as Associate Professor at the Department of Cardiology, School of Medicine, Kochi.
Year of Publication | Publication Type | Title |
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2017 |
Journal Article |
M. Subramanian, Prabhu, M. A., Harikrishnan, M. S., Dr. Saritha Sekhar S., Pai, P. G., and Natarajan, K. Uma, “The Utility of Exercise Testing in Risk Stratification of Asymptomatic Patients with type 1 Brugada Pattern”, Journal of Cardiovascular Electrophysiology, vol. 28, no. 6, pp. 677-683, 2017.[Abstract] INTRODUCTION: Risk stratification of asymptomatic patients with a Brugada type 1 ECG pattern remains an unresolved clinical conundrum. In contrast to provocative pharmacological testing in Brugada syndrome, there is limited data on the role of exercise stress testing as a risk stratification modality. The objective of this study was to evaluate the utility of exercise testing in asymptomatic patients with type 1 Brugada pattern to prognosticate major arrhythmic events(MAE) during follow-up. METHODS AND RESULTS: Treadmill exercise testing was conducted for 75 asymptomatic patients with type 1 Brugada pattern and for 88 healthy control subjects. The clinical end point of MAE was defined as the occurrence of sudden cardiac death(SCD) or resuscitated ventricular fibrillation(VF). During a follow-up of 77.9±28.9 months, 8 MAE occurred(5 VF and 3 SCD). Multivariate Cox regression analysis showed that the following were independent predictors of MAE in asymptomatic patients with a type 1 Brugada pattern: increase in S wave upslope duration ratio >30% at peak exercise(HR 1.35, 95% CI 1.08-10.97,p = 0.023),augmentation of J point elevation in lead aVR> 2mm in late recovery(HR 1.88, 95% 1.21 - 15.67,p = 0.011) and delayed HR recovery(HR 1.14, 95% CI 1.06-18.22,p = 0.042). A high risk cohort was identified by the final step wise regression model with good accuracy (specificity = 98.4%,sensitivity = 62.5%) and discriminative power(AUC = 0.93,95%CI 0.89-0.96,p = 0.002). Kaplan Meier analysis revealed that there increasing MAE in subjects with one, two,or three predictors(log rank p<0.001). CONCLUSIONS: Exercise testing in asymptomatic patients with Type 1 Brugada pattern aids in identification of high risk patients and provides a unique window of opportunity for early intervention. This article is protected by copyright. All rights reserved. More »» |
2016 |
Journal Article |
Dr. Saritha Sekhar S., Vupputuri, A., Nair, R. Chandrasek, Palaniswamy, S. Sundaram, and Natarajan, K. Uma, “Coronary Stent Infection Successfully Diagnosed Using 18F-Flurodeoxyglucose Positron Emission Tomography Computed Tomography.”, The Canadian Journal of Cardiology, vol. 32, no. 12, pp. 1575.e1-1575.e3, 2016.[Abstract] Infection of coronary stents is extremely rare. We report a case of a 60-year-old gentleman with recurrent fever after acute stent occlusion and reintervention. A coronary angiogram showed an occluded stented segment and the blood cultures were positive for infection. The presence of inflammation in the stented region was confirmed using 18F-flurodeoxyglucose positron emission tomography computed tomography. The patient underwent surgery and the diagnosis was proven by examination of the surgical material. This article highlights the need to have a high index of suspicion of stent infection, and the use of 18F-flurodeoxyglucose positron emission tomography computed tomography along with coronary angiogram in aiding the diagnosis. More »» |