Objectives: The aim behind this study was to scientifically determine the incidence of arrhythmias and associated patient’s outcome in hospitalized acute coronary syndrome patients. Study Design: Observational Hospital Based study. Setting: Department of Cardiology, Isra University Hospital Hyderabad. Period: One year from 26th March 2018 to 25th March 2019. Material & Methods: A total of 177 patients were included having age 20 to 70 years both male and female. Data were entered and analyzed by using Statistical Package for the Social Sciences version 20.0. Results: The mean age of patients was 48.23±12.9 years with predominantly males (58.19%). The most commonly observed risk factor in our study was cigarette smoking (N = 96, 54.23%) The overall incidence of arrhythmias irrespective of their origin within acute phase was observed 12.99% (N = 23) out of total 151 admitted patients. Among these 23 cases, the ventricular arrhythmias were more common than atrial arrhythmias, (N = 17, 73.91%) and (N = 06, 26.08%), respectively. Only 2 (8.69%) cases experienced complications related to arrhythmias. Conclusion: Ventricular origin arrhythmias are more commonly observed in our study and were also associated with fatal complications as compared to atrial arrhythmias.

Objectives: The aim behind this study was to scientifically correlate theglycosylated hemoglobin and lipid profile with the complexity of coronary artery disease. StudyDesign: Comparative hospital based study. Setting: Cardiology Department of Isra UniversityHospital Hyderabad. Period: Six months. Patients and Methods: 112 participants between theages of 25 to 80 years both male and female and undergoing their first coronary angiographywas included. Data were entered and analyzed by using Statistical Package for the SocialSciences version 20.0. Results: The mean age of patients was 54.16 years (9.74 ± SD) and thestudy subjects consisted of 76 males (67.86%) and 36 (32.14%) females. a total of 65 patients(58.0%) were presented between the ages of 41 – 60 years (middle aged group). The meanSYNTAX Score was 15.22. Patients with increased HbA1C (≥6.5%) and triglyceride levels (≥150mg/dl) and decreased HDL-C levels (≤40 mg/dl) were tend to have high Sx score. However,we did not find any significant relationship of SX score with total cholesterol and LDL-C levels.Conclusion: It was found that the trend of complexity of CAD increased with increasing age,high HbA1C, high LDL-C, high serum triglyceride, and low HDL-C levels.

Objective: The objective of this study was to assess the frequency of cardiogenic shock in patients of younger than 45 years of age presenting with NSTEMI. Methodology: A hospital based Cross sectional study has been conducted in a tertiary hospital of Isra University Hospital, Hyderabad in the Department of Cardiology. This study was started in September 2017 and completed on March 2019 and recruited a total of 321 patients NSTEMI patients having age less than 45 years of either gender to determine the burden of cardiogenic shock during hospitalization. Baseline and clinical data were recorded in a pre-structured questionnaire and analyzed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results: Out of total 321 patients the mean age of admitted NSTEMI patients was 37.34 ± 6.19 years and among them male predominance was prevalent (72.8%, N = 234). The overall burden of cardiogenic shock in our study subjects was 19(5.9%). Male gender, cigarette smoking, diabetes mellitus, chronic kidney disease, and increased mean duration of hospital stay were significantly associated with cardiogenic shock in patients admitted with NSTEMI as compared to patients admitted without cardiogenic shock (p<0.05). Conclusion: Our study shows that overall burden of cardiogenic shock is higher in patients with younger age group when they are diabetic, had underlying chronic kidney disease, and increased duration of hospital stay.

Objective: To determine the prevalence of first diagnosed atrial fibrillation in patients admitted with acute coronary syndrome and with impaired renal function with and without diabetes mellitus. Methodology: A total of 434 patients were selected from two different hospitals, 361 from NICVD, Tando Muhammad Khan and 73 from Isra University Hospital, Hyderabad. Both males and females, aged between 18 years to 70 years, first ever presented & admitted with acute coronary syndrome (ACS) and renal impairment were included and whereas, patients with atrial fibrillation (AF) other than first diagnosed, previous history of myocardial infarction/coronary artery bypass grafting (CABG), known case of chronic kidney disease/on dialysis, history of cerebrovascular accident (CVA), patient with valvular heart disease, and pregnant women were excluded from this study. Baseline and clinical data was collected to determine the association with the prevalence of first diagnosed AF through chi-square test and a p value of <0.05 was considered as statistically significant. Results: The mean age ± SD was 49.32±12.47 years. Among them majority were males 66.35% and rural residents 51.15% respectively. The most common risk factor observed in our study was presence of hypertension (N = 231, 53.22%) and among all ACS patients, most common type of ACS was unstable angina (N = 195, 44.93%). The overall prevalence of first diagnosed atrial fibrillation was 12.44% (N = 54) and the overall prevalence of diabetes mellitus was 39.63% (N = 172). Mean random blood sugar levels in diabetic patients was 203.32±105.60 mg/dL, hypertensive patients with DM (48.14%), and patients with STEMI with DM (12.96%) were significantly associated with increased prevalence of first diagnosed atrial fibrillation, p value <0.05. Conclusion: Prevalence of first diagnosed AF is comparatively higher in our study because of the underlying renal impairment. Modifiable risk factor like uncontrolled blood sugar levels has significance association with first diagnosed AF.

Objective: Supraventricular tachycardia (SVT) is the most common presentation of patients at cardiac emergency department. This study aims to determine the quality of life in patients with supraventricular tachycardia after they treated with medicines vs. ablation therapy. Methods: This prospective clinical comparative study was held at the National Institute of Cardiovascular Diseases (NICVD). Patients 18 years or older of either gender presenting with the two most common variants of SVT i.e. Atrioventricular nodal reentry tachycardia (AVNRT) and Atrioventricular reentry tachycardia (AVRT) were eligible to be included into the study. Once stabilized at the emergency department (ED) the patients were given the option to undergo electrophysiology study and radiofrequency ablation (EPS and RFA) (group A) or opt for medications only (group B). Quality of life (sense of personal well being, impact on social life, fear of mortality or anxiety about the disease, recurrence of episodes of arrhythmia, and visits to ED) was assessed through a questionnaire filled after six months of receiving treatment. Results: A total of 120 patients were included into our study. Group A and group B were evenly divided with 60 patients each. The overall mean age of the participants and duration of cardiac illness were 44.67±18.91 and 5.42±3.13 years, respectively. Patients who received EPS and RFA (group A) had superior and statistically significant scores (better QoL) for sense of personal well being, impact on social life, fear of mortality or anxiety levels, recurrence of arrhythmia, and visits to the ED as compared to those who received medications alone, p<0.05. Conclusion: EPS and RFA vastly improved the quality of life in patients with SVT post treatment. Medications alone are associated with a high number of post treatment sequels and adverse events; therefore they are best avoided in patients with SVT.