Kartikeya Bhargava - Academia.edu (original) (raw)

Papers by Kartikeya Bhargava

Research paper thumbnail of Pacing site for biventricular pacing in patients of severe heart failure

Heart Rhythm, 2005

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2005 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not ...

Research paper thumbnail of DF-4 Lead Connector: Innovative Technology, Unexpected Problems and Novel Solutions

Indian pacing and electrophysiology journal, 2014

Research paper thumbnail of Cardiac Sarcoidosis - Arrhythmias, Inflammation and Anti-inflammatory Drug Therapy

Indian pacing and electrophysiology journal, 2012

Sarcoidosis is a multi-system granulomatous disease of unclear etiology with variable presentatio... more Sarcoidosis is a multi-system granulomatous disease of unclear etiology with variable presentation. The common sites of involvement include the lungs and the lymphnodes, though many other organs including liver, spleen, skin, eyes, and even the heart can get involved. The pathological hallmark of this disease is a non-caseating granuloma.

Research paper thumbnail of Regarding Article 'Multiple Episodes of Presyncope in a Pacemaker Dependent Patient: What is the Diagnosis?

Indian pacing and electrophysiology journal, 2010

I read with interest the article describing repetitive non-reentrant ventriculo-atrial synchrony ... more I read with interest the article describing repetitive non-reentrant ventriculo-atrial synchrony (RNRVAS) as an explanation for the recorded marker channels and presyncope in a pacemaker dependent patient . Though, the mechanism explained is plausible, I suggest an alternative and more common mechanism as a likely explanation of the intra-cardiac recording.

Research paper thumbnail of Dislodgement of Atrial Lead of the CRT-D System and Its Migration into the Pocket Presenting as Its Absence on Chest X-Ray

Pacing and Clinical Electrophysiology, 2007

Lead dislodgement and migration is a known complication after implantation of cardiac rhythm devi... more Lead dislodgement and migration is a known complication after implantation of cardiac rhythm devices. We present a case of dislodgement of atrial lead of the CRT-D system and its migration into the device pocket. The device itself had rotated by 90 degrees but the right and left ventricular leads were not at all affected. The case is unique because the lead had coiled up and was lying behind the device in the pocket and hence was not even seen on a chest x-ray.

Research paper thumbnail of An example of combined sinoatrial and atrioventricular block

Journal of Electrocardiology, 2008

Combined sinoatrial and atrioventricular block is rare and has been reported in patients on digit... more Combined sinoatrial and atrioventricular block is rare and has been reported in patients on digitalis. We report a case of combined Mobitz type II sinoatrial block and 2:1 atrioventricular block in a patient on no medication who presented with recurrent syncope.

Research paper thumbnail of Narrow QRS incessant tachycardia in a patient with recent myocardial infarction: What is the mechanism?

Heart Rhythm, 2008

A 50-year-old, nondiabetic, nonhypertensive man presented with palpitations for 2 hours. He had s... more A 50-year-old, nondiabetic, nonhypertensive man presented with palpitations for 2 hours. He had sustained an anteroseptal myocardial infarction 10 days earlier followed 2 days later by angioplasty and stenting to the left anterior descending artery. His left ventricular ejection fraction was 40%. The electrocardiogram (ECG) during palpitations revealed a narrow QRS tachycardia ( , right half) with QRS morphology similar in several leads to that during sinus rhythm ( , left half). The tachycardia was incessant and hemodynamically stable and did not respond to carotid massage, adenosine, diltiazem, or amiodarone. An electrophysiology (EP) study was performed, and intracardiac electrograms during the tachycardia showed nearly simultaneous activation of the atria and ventricles. The intracardiac electrograms during high right atrial pacing and during tachycardia are shown in . What is the mechanism of this incessant narrow QRS tachycardia?

Research paper thumbnail of Interesting ECG Narrow QRS Tachycardia with Alternate Wide QRS Beats: What is the Mechanism?

A 44-year old lady underwent electrophysiology study for recurrent palpitations and documented na... more A 44-year old lady underwent electrophysiology study for recurrent palpitations and documented narrow QRS regular tachycardia. The baseline ECG showed subtle preexcitation that was easily manifest on atrial pacing. The retrograde atrial activation sequence during ventricular pacing was eccentric suggesting retrograde conduction over the accessory pathway. A regular narrow QRS tachycardia with cycle length 280 ms was easily inducible on

Research paper thumbnail of Protein C deficiency leading to pulmonary thromboembolism in a patient with hereditary spherocytosis

Indian heart journal

Hereditary protein C deficiency results in a hypercoagulable state that can manifest itself as ve... more Hereditary protein C deficiency results in a hypercoagulable state that can manifest itself as venous thrombosis and pulmonary embolism. The prevalence of this condition, even among patients with familial thrombosis, is quite low. We report a case of protein C deficiency presenting as massive pulmonary thromboembolism in a patient with hereditary spherocytosis, an uncommon hemolytic disorder not usually associated with increased thrombotic risk. A review of the literature revealed only a few cases of thrombosis associated with hereditary spherocytosis, and none of them had protein C deficiency. This makes the present case the first of its kind to be reported.

Research paper thumbnail of Entrainment during Ablation of Ischemic Ventricular Tachycardia. What is explanation for Post Pacing Interval shorter than the tachycardia cycle length?

Indian pacing and electrophysiology journal, 2011

Entrainment mapping of ischemic ventricular tachycardia at a site in the left ventricle where rad... more Entrainment mapping of ischemic ventricular tachycardia at a site in the left ventricle where radiofrequency ablation was successful in terminating the tachycardia revealed a post-pacing interval shorter than the tachycardia cycle length. The reason for the same is explained in the current report.

Research paper thumbnail of Perspective Carotid Intima-Media Thickness and Coronary Artery Disease: an Indian

Research paper thumbnail of Unusual Response to His-Synchronous Ventricular Extra-Stimulation during a Supraventricular Tachycardia: What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

A 47-year-old woman underwent electrophysiology study for recurrent episodes of documented paroxy... more A 47-year-old woman underwent electrophysiology study for recurrent episodes of documented paroxysmal supraventricular tachycardia (SVT) that used to terminate easily with adenosine. The electrocardiogram (ECG) during baseline was normal and that during clinical SVT was suggestive of atrioventricular nodal reentrant tachycardia (AVNRT). The basic intervals were normal and ventricular pacing showed concentric retrograde atrial activation sequence with evidence of ventriculoatrial (VA) block on adenosine. Atrial-His (AH) jump suggesting dual atrioventricular (AV) nodal physiology was seen on

Research paper thumbnail of A Tachycardia classified as Supraventricular by a Cardiac Resynchronization Therapy-Defibrillator Device. What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

Research paper thumbnail of Intermittent Single NonTracked P Waves Immediately after Dual-Chamber Pacemaker Implantation for Complete AV Block. What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

A 65-year-old woman underwent dualchamber permanent pacemaker implantation for degenerative compl... more A 65-year-old woman underwent dualchamber permanent pacemaker implantation for degenerative complete atrioventricular (AV) block. The measured P/R waves, pacing threshold, and impedance obtained through the analyzer were 4 mV, 0.5 V at 0.4 ms and 620 and 16 mV, 0.3 V at 0.4 ms and 580 , respectively, in the implanted passive-fixation bipolar atrial and ventricular leads. The leads were connected to the pulse generator (Sensia SEDR01, Medtronic Inc., Minneapolis, MN, USA) with nominal parameters (except the mode that was changed to DDD, others being lower rate 60/min, upper tracking rate 130/min, AV delay sensed and paced 120 and 150 ms, rate-adaptive AV delay off, and mode switch on at detect rate of 175/min), and the device was placed in the subcutaneous pocket created earlier. Intermittent loss of tracking of single P waves was noted immediately on the electrocardiogram monitor . The leads were verified to be in optimal position on fluoroscopy and the device was then interrogated. The electrogram obtained from the programmer during the loss of atrial tracking is shown in . The sensing and pacing parameters obtained through the programmer were as follows: atrial-P wave 3.5 mV, threshold 0.5 V at 0.4 ms, impedance 625 and ventricular-R wave 15.68 mV, threshold 0.5 V at 0.4 ms, and impedance 560 . The problem persisted despite turning off search AV+, noncompetitive atrial pacing and premature ventricular contraction response, and changing the postven-Conflicts of Interest: None.

Research paper thumbnail of Ventricular Fibrillation in the EP Lab. What is the Atrial Rhythm?

Journal of Cardiovascular Electrophysiology, 2008

An 81-year-old gentleman presented with recurrent episodes of syncope. He had no episodes of palp... more An 81-year-old gentleman presented with recurrent episodes of syncope. He had no episodes of palpitations or angina. His echocardiography study was normal and stress test and head-up tilt test were negative. The baseline ECG showed incomplete right bundle branch block. He was taken up for an electrophysiology study under local anesthesia in conscious nonsedated state. A 6F diagnostic quadripolar catheter was placed in the high right atrium through the right

Research paper thumbnail of Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular pacemaker implantation

Heart Rhythm, 2007

1. Heart Rhythm. 2007 Jun;4(6):810. Epub 2006 Sep 16. Persistent left superior vena cava opening ... more 1. Heart Rhythm. 2007 Jun;4(6):810. Epub 2006 Sep 16. Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular pacemaker implantation. Bhargava K, Arora V, Kler TS. ...

Research paper thumbnail of Change in atrial activation sequence during orthodromic reciprocating tachycardia: What is the mechanism?

Heart Rhythm, 2007

A 62-year-old woman underwent electrophysiologic study for recurrent palpitations and documented ... more A 62-year-old woman underwent electrophysiologic study for recurrent palpitations and documented narrow QRS tachycardia. ECG and AH and HV intervals at baseline were normal. Earliest retrograde atrial activation during ventricular pacing was noted in the distal coronary sinus (CS). Programmed atrial stimulation consistently induced a narrow QRS tachycardia with cycle length 300 ms and VA interval (high right atrium) 175 ms. Retrograde atrial activation sequence during the tachycardia was same as during ventricular pacing. A diagnosis of orthodromic reciprocating tachycardia (ORT) with concealed left free-wall accessory pathway (AP) was made. Ablation of the AP via a retrograde aortic approach was planned. Introduction of the ablation catheter into the left ventricle led to inadvertent trauma resulting in left bundle branch block. ORT with cycle length 325 ms, left bundle branch block morphology, and the same retrograde atrial activation sequence still was inducible. Mapping at the mitral annulus revealed a site with earliest atrial activation during tachycardia. Radiofrequency (RF) energy application at this site resulted in separation of V and A electrograms but apparent continuation of the tachycardia ( ). Unfortunately, a few seconds after this separation occurred, the ablation catheter jumped, and RF application was terminated prematurely. The original ORT resumed after a few seconds ). The ablation catheter was again positioned at a site in the mitral annulus with earliest retrograde atrial activation. RF ablation this time resulted in prompt termination of the tachycardia. No evidence of AP was seen after ablation , and no tachycardia was inducible with atrial or ventricular stimulation, even with isoproterenol. At 3-month follow-up, the patient is asymptomatic and taking no medications. What is the explanation for the change in atrial activation sequence seen in and for the variable relationship between the atrial electrograms recorded at the His-bundle region and high right atrium seen in ?

Research paper thumbnail of Pulmonary Artery Catheter Burn After Multiple Transthoracic Defibrillatory Shocks

Anesthesia & Analgesia, 2006

... Munish Sharma, MD, DNB, MNAMS Kartikeya Bhargava, MD, DNB (Cardiology) Yatin Mehta, MD, DNB, ... more ... Munish Sharma, MD, DNB, MNAMS Kartikeya Bhargava, MD, DNB (Cardiology) Yatin Mehta, MD, DNB, FRCA, FAMS Naresh Trehan, MD Escorts Heart ... pain (VAS-OP) rated on a 100-mm VAS, injection pain score (VAS-IN), surgeon satisfaction score (VAS-SS), operative time ...

Research paper thumbnail of AV block. Which type and where?

Journal of Electrocardiology, 2007

An electrocardiogram (ECG) showing sinus tachycardia with sinus rate exceeding the ventricular ra... more An electrocardiogram (ECG) showing sinus tachycardia with sinus rate exceeding the ventricular rate suggesting atrio-ventricular (AV) block in a patient with old anterior wall infarction is presented. The presence of varying PR intervals, irregular RR intervals and P-QRS relationship not consistent with 2nd degree type 1 AV block was seen. The possible site(s) and degree of AV block in the case is discussed. D . Twelve-lead ECG showing a regular sinus rhythm at 115/min, with more P waves than QRS complexes. The RR intervals are irregular, but a repetitive pattern of the irregularity is present. The QRS shows low voltage and an extensive old anteroapical myocardial infarction.

Research paper thumbnail of Pacing site for biventricular pacing in patients of severe heart failure

Heart Rhythm, 2005

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2005 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your institution. ... Advertisements on this site do not ...

Research paper thumbnail of DF-4 Lead Connector: Innovative Technology, Unexpected Problems and Novel Solutions

Indian pacing and electrophysiology journal, 2014

Research paper thumbnail of Cardiac Sarcoidosis - Arrhythmias, Inflammation and Anti-inflammatory Drug Therapy

Indian pacing and electrophysiology journal, 2012

Sarcoidosis is a multi-system granulomatous disease of unclear etiology with variable presentatio... more Sarcoidosis is a multi-system granulomatous disease of unclear etiology with variable presentation. The common sites of involvement include the lungs and the lymphnodes, though many other organs including liver, spleen, skin, eyes, and even the heart can get involved. The pathological hallmark of this disease is a non-caseating granuloma.

Research paper thumbnail of Regarding Article 'Multiple Episodes of Presyncope in a Pacemaker Dependent Patient: What is the Diagnosis?

Indian pacing and electrophysiology journal, 2010

I read with interest the article describing repetitive non-reentrant ventriculo-atrial synchrony ... more I read with interest the article describing repetitive non-reentrant ventriculo-atrial synchrony (RNRVAS) as an explanation for the recorded marker channels and presyncope in a pacemaker dependent patient . Though, the mechanism explained is plausible, I suggest an alternative and more common mechanism as a likely explanation of the intra-cardiac recording.

Research paper thumbnail of Dislodgement of Atrial Lead of the CRT-D System and Its Migration into the Pocket Presenting as Its Absence on Chest X-Ray

Pacing and Clinical Electrophysiology, 2007

Lead dislodgement and migration is a known complication after implantation of cardiac rhythm devi... more Lead dislodgement and migration is a known complication after implantation of cardiac rhythm devices. We present a case of dislodgement of atrial lead of the CRT-D system and its migration into the device pocket. The device itself had rotated by 90 degrees but the right and left ventricular leads were not at all affected. The case is unique because the lead had coiled up and was lying behind the device in the pocket and hence was not even seen on a chest x-ray.

Research paper thumbnail of An example of combined sinoatrial and atrioventricular block

Journal of Electrocardiology, 2008

Combined sinoatrial and atrioventricular block is rare and has been reported in patients on digit... more Combined sinoatrial and atrioventricular block is rare and has been reported in patients on digitalis. We report a case of combined Mobitz type II sinoatrial block and 2:1 atrioventricular block in a patient on no medication who presented with recurrent syncope.

Research paper thumbnail of Narrow QRS incessant tachycardia in a patient with recent myocardial infarction: What is the mechanism?

Heart Rhythm, 2008

A 50-year-old, nondiabetic, nonhypertensive man presented with palpitations for 2 hours. He had s... more A 50-year-old, nondiabetic, nonhypertensive man presented with palpitations for 2 hours. He had sustained an anteroseptal myocardial infarction 10 days earlier followed 2 days later by angioplasty and stenting to the left anterior descending artery. His left ventricular ejection fraction was 40%. The electrocardiogram (ECG) during palpitations revealed a narrow QRS tachycardia ( , right half) with QRS morphology similar in several leads to that during sinus rhythm ( , left half). The tachycardia was incessant and hemodynamically stable and did not respond to carotid massage, adenosine, diltiazem, or amiodarone. An electrophysiology (EP) study was performed, and intracardiac electrograms during the tachycardia showed nearly simultaneous activation of the atria and ventricles. The intracardiac electrograms during high right atrial pacing and during tachycardia are shown in . What is the mechanism of this incessant narrow QRS tachycardia?

Research paper thumbnail of Interesting ECG Narrow QRS Tachycardia with Alternate Wide QRS Beats: What is the Mechanism?

A 44-year old lady underwent electrophysiology study for recurrent palpitations and documented na... more A 44-year old lady underwent electrophysiology study for recurrent palpitations and documented narrow QRS regular tachycardia. The baseline ECG showed subtle preexcitation that was easily manifest on atrial pacing. The retrograde atrial activation sequence during ventricular pacing was eccentric suggesting retrograde conduction over the accessory pathway. A regular narrow QRS tachycardia with cycle length 280 ms was easily inducible on

Research paper thumbnail of Protein C deficiency leading to pulmonary thromboembolism in a patient with hereditary spherocytosis

Indian heart journal

Hereditary protein C deficiency results in a hypercoagulable state that can manifest itself as ve... more Hereditary protein C deficiency results in a hypercoagulable state that can manifest itself as venous thrombosis and pulmonary embolism. The prevalence of this condition, even among patients with familial thrombosis, is quite low. We report a case of protein C deficiency presenting as massive pulmonary thromboembolism in a patient with hereditary spherocytosis, an uncommon hemolytic disorder not usually associated with increased thrombotic risk. A review of the literature revealed only a few cases of thrombosis associated with hereditary spherocytosis, and none of them had protein C deficiency. This makes the present case the first of its kind to be reported.

Research paper thumbnail of Entrainment during Ablation of Ischemic Ventricular Tachycardia. What is explanation for Post Pacing Interval shorter than the tachycardia cycle length?

Indian pacing and electrophysiology journal, 2011

Entrainment mapping of ischemic ventricular tachycardia at a site in the left ventricle where rad... more Entrainment mapping of ischemic ventricular tachycardia at a site in the left ventricle where radiofrequency ablation was successful in terminating the tachycardia revealed a post-pacing interval shorter than the tachycardia cycle length. The reason for the same is explained in the current report.

Research paper thumbnail of Perspective Carotid Intima-Media Thickness and Coronary Artery Disease: an Indian

Research paper thumbnail of Unusual Response to His-Synchronous Ventricular Extra-Stimulation during a Supraventricular Tachycardia: What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

A 47-year-old woman underwent electrophysiology study for recurrent episodes of documented paroxy... more A 47-year-old woman underwent electrophysiology study for recurrent episodes of documented paroxysmal supraventricular tachycardia (SVT) that used to terminate easily with adenosine. The electrocardiogram (ECG) during baseline was normal and that during clinical SVT was suggestive of atrioventricular nodal reentrant tachycardia (AVNRT). The basic intervals were normal and ventricular pacing showed concentric retrograde atrial activation sequence with evidence of ventriculoatrial (VA) block on adenosine. Atrial-His (AH) jump suggesting dual atrioventricular (AV) nodal physiology was seen on

Research paper thumbnail of A Tachycardia classified as Supraventricular by a Cardiac Resynchronization Therapy-Defibrillator Device. What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

Research paper thumbnail of Intermittent Single NonTracked P Waves Immediately after Dual-Chamber Pacemaker Implantation for Complete AV Block. What is the Mechanism?

Pacing and Clinical Electrophysiology, 2011

A 65-year-old woman underwent dualchamber permanent pacemaker implantation for degenerative compl... more A 65-year-old woman underwent dualchamber permanent pacemaker implantation for degenerative complete atrioventricular (AV) block. The measured P/R waves, pacing threshold, and impedance obtained through the analyzer were 4 mV, 0.5 V at 0.4 ms and 620 and 16 mV, 0.3 V at 0.4 ms and 580 , respectively, in the implanted passive-fixation bipolar atrial and ventricular leads. The leads were connected to the pulse generator (Sensia SEDR01, Medtronic Inc., Minneapolis, MN, USA) with nominal parameters (except the mode that was changed to DDD, others being lower rate 60/min, upper tracking rate 130/min, AV delay sensed and paced 120 and 150 ms, rate-adaptive AV delay off, and mode switch on at detect rate of 175/min), and the device was placed in the subcutaneous pocket created earlier. Intermittent loss of tracking of single P waves was noted immediately on the electrocardiogram monitor . The leads were verified to be in optimal position on fluoroscopy and the device was then interrogated. The electrogram obtained from the programmer during the loss of atrial tracking is shown in . The sensing and pacing parameters obtained through the programmer were as follows: atrial-P wave 3.5 mV, threshold 0.5 V at 0.4 ms, impedance 625 and ventricular-R wave 15.68 mV, threshold 0.5 V at 0.4 ms, and impedance 560 . The problem persisted despite turning off search AV+, noncompetitive atrial pacing and premature ventricular contraction response, and changing the postven-Conflicts of Interest: None.

Research paper thumbnail of Ventricular Fibrillation in the EP Lab. What is the Atrial Rhythm?

Journal of Cardiovascular Electrophysiology, 2008

An 81-year-old gentleman presented with recurrent episodes of syncope. He had no episodes of palp... more An 81-year-old gentleman presented with recurrent episodes of syncope. He had no episodes of palpitations or angina. His echocardiography study was normal and stress test and head-up tilt test were negative. The baseline ECG showed incomplete right bundle branch block. He was taken up for an electrophysiology study under local anesthesia in conscious nonsedated state. A 6F diagnostic quadripolar catheter was placed in the high right atrium through the right

Research paper thumbnail of Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular pacemaker implantation

Heart Rhythm, 2007

1. Heart Rhythm. 2007 Jun;4(6):810. Epub 2006 Sep 16. Persistent left superior vena cava opening ... more 1. Heart Rhythm. 2007 Jun;4(6):810. Epub 2006 Sep 16. Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular pacemaker implantation. Bhargava K, Arora V, Kler TS. ...

Research paper thumbnail of Change in atrial activation sequence during orthodromic reciprocating tachycardia: What is the mechanism?

Heart Rhythm, 2007

A 62-year-old woman underwent electrophysiologic study for recurrent palpitations and documented ... more A 62-year-old woman underwent electrophysiologic study for recurrent palpitations and documented narrow QRS tachycardia. ECG and AH and HV intervals at baseline were normal. Earliest retrograde atrial activation during ventricular pacing was noted in the distal coronary sinus (CS). Programmed atrial stimulation consistently induced a narrow QRS tachycardia with cycle length 300 ms and VA interval (high right atrium) 175 ms. Retrograde atrial activation sequence during the tachycardia was same as during ventricular pacing. A diagnosis of orthodromic reciprocating tachycardia (ORT) with concealed left free-wall accessory pathway (AP) was made. Ablation of the AP via a retrograde aortic approach was planned. Introduction of the ablation catheter into the left ventricle led to inadvertent trauma resulting in left bundle branch block. ORT with cycle length 325 ms, left bundle branch block morphology, and the same retrograde atrial activation sequence still was inducible. Mapping at the mitral annulus revealed a site with earliest atrial activation during tachycardia. Radiofrequency (RF) energy application at this site resulted in separation of V and A electrograms but apparent continuation of the tachycardia ( ). Unfortunately, a few seconds after this separation occurred, the ablation catheter jumped, and RF application was terminated prematurely. The original ORT resumed after a few seconds ). The ablation catheter was again positioned at a site in the mitral annulus with earliest retrograde atrial activation. RF ablation this time resulted in prompt termination of the tachycardia. No evidence of AP was seen after ablation , and no tachycardia was inducible with atrial or ventricular stimulation, even with isoproterenol. At 3-month follow-up, the patient is asymptomatic and taking no medications. What is the explanation for the change in atrial activation sequence seen in and for the variable relationship between the atrial electrograms recorded at the His-bundle region and high right atrium seen in ?

Research paper thumbnail of Pulmonary Artery Catheter Burn After Multiple Transthoracic Defibrillatory Shocks

Anesthesia & Analgesia, 2006

... Munish Sharma, MD, DNB, MNAMS Kartikeya Bhargava, MD, DNB (Cardiology) Yatin Mehta, MD, DNB, ... more ... Munish Sharma, MD, DNB, MNAMS Kartikeya Bhargava, MD, DNB (Cardiology) Yatin Mehta, MD, DNB, FRCA, FAMS Naresh Trehan, MD Escorts Heart ... pain (VAS-OP) rated on a 100-mm VAS, injection pain score (VAS-IN), surgeon satisfaction score (VAS-SS), operative time ...

Research paper thumbnail of AV block. Which type and where?

Journal of Electrocardiology, 2007

An electrocardiogram (ECG) showing sinus tachycardia with sinus rate exceeding the ventricular ra... more An electrocardiogram (ECG) showing sinus tachycardia with sinus rate exceeding the ventricular rate suggesting atrio-ventricular (AV) block in a patient with old anterior wall infarction is presented. The presence of varying PR intervals, irregular RR intervals and P-QRS relationship not consistent with 2nd degree type 1 AV block was seen. The possible site(s) and degree of AV block in the case is discussed. D . Twelve-lead ECG showing a regular sinus rhythm at 115/min, with more P waves than QRS complexes. The RR intervals are irregular, but a repetitive pattern of the irregularity is present. The QRS shows low voltage and an extensive old anteroapical myocardial infarction.