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Papers by Surendra Chutani

Indian heart journal, Nov 1, 2014

Case Reports, May 13, 2009

Brugada syndrome is one of the important causes of sudden cardiac death in young adults. The cond... more Brugada syndrome is one of the important causes of sudden cardiac death in young adults. The condition is associated with typical electrocardiogram (ECG) changes in anteroseptal leads V1 and V2 that can be unmasked by various medications, electrolyte disturbances, and even by the febrile state in susceptible individuals. The case history is reported of a patient with atrial flutter and atrial fibrillation who developed Brugada-like ECG changes when treated with propafenone. He was mistakenly diagnosed as having acute myocardial infarction when he presented to the emergency room with acute precordial chest pain. Cardiac catheterisation revealed normal coronary arteries and normal left ventricular systolic function. A review of previous ECGs showed the temporal relationship of ECG changes to initiation of propafenone a few years earlier. The ECG changes resolved with discontinuation of propafenone and re-emerged when he was rechallenged with oral propafenone. This case highlights the importance of recognising the characteristic ECG changes of Brugada syndrome and being able to differentiate them from those of acute myocardial infarction and other conditions manifesting with similar changes.

European Heart Journal, Aug 1, 2018

European Heart Journal, 2018

Indian pacing and electrophysiology journal, Jul 1, 2017

Journal of Interventional Cardiac Electrophysiology, 2021

Purpose Response to cardiac resynchronization therapy (CRT) in patients with heart failure with r... more Purpose Response to cardiac resynchronization therapy (CRT) in patients with heart failure with reduced ejection fraction (HFrEF) depends on the degree of correction of interventricular (VV) electromechanical dyssynchrony between the left and right ventricles (LV, RV). Wide (> 130 ms [ms]) QRS interval is used as a qualifying ECG parameter for CRT device implantation. In this study, we aimed to evaluate myocardial strain (S) and myocardial strain patterns (SP) and strain rate (SR) by speckle tracking echocardiography (STE) and mechanical characteristics at different VV intervals in acute settings and long-term outcome from “sequential LV-RV” pacing programming in patients with narrow (< 130 ms) and wide (> 130 ms) QRS complexes as a basis for extending CRT in select patients with narrow QRS. Methods From a previously established cohort of patients who had undergone CRT device implantation, we identified patients with narrow (< 130 ms) and wide (> 130 ms) QRS complexes...

International Journal of Heart Rhythm, 2018

Scientific growth in the field of magnetic resonance imaging (MRI) and cardiac devices has been e... more Scientific growth in the field of magnetic resonance imaging (MRI) and cardiac devices has been exponential in recent decades. Cardiac implantable electronic devices due to their ferromagnetic constituents in leads and device body have always been an issue if patients need MRI. MRI is relatively safe. Recent introduction of changes in leads and device body constituents renders them less ferromagnetic, making MRI less frightening to a certain extent. Simultaneously, there is increasing research interest in MRI. Not only anatomy and pathology but also physiology of cardiac and nervous structures can be imaged. It is estimated that 53%–64% of intracardiac defibrillator (ICD) patients will require an MRI determination over a 10-year time horizon, highlighting the importance of MRI-conditional devices for this patient population. In this article, we briefly describe evolution and current status of conditioning of cardiac devices to make them MRI-friendly and briefly discuss where we are in terms of our physician role with respect to MRI-conditional devices.

Cardiological Society of India Cardiology Update 2014, 2015

Catheterization and Cardiovascular Interventions

Journal of atrial fibrillation, 2014

J wave syndrome has emerged from a benign electrocardiographic abnormality to a proarrythmic stat... more J wave syndrome has emerged from a benign electrocardiographic abnormality to a proarrythmic state and a significant cause of idiopathic ventricular fibrillation responsible for sudden cardiac death. Electrical genesis, genetics and ionic mechanisms of J wave syndromes are active areas of research. Typically two of these viz., Early repolarization syndrome (ER) and Brugada syndrome (BrS) are fairly well characterized enabling correct diagnosis in most patients. In early repolarization syndrome, J waves are seen in inferior (2,3, avF) or lateral leads (V4, V5, V6), while in Brugada syndrome they are best seen in right precordial leads (V1-V3). The first part of repolarization of ventricular myocardium is governed by Ito current i.e., rapid outward potassium current. The proposed mechanism of ventricular fibrillation (VF) and ventricular tachycardia (VT) storms is faster Ito current in the epicardium than in the endocardium resulting in electrical gradient that forms the substrate for...

Current Opinion in Cardiology, 2016

Pacemakers are frequently implanted in patients with atrial fibrillation. Many patients with pace... more Pacemakers are frequently implanted in patients with atrial fibrillation. Many patients with pacemakers also develop atrial fibrillation. Over a period of time, through many studies on different pacing modes, sites, and algorithms, significant insights have been gained in the field of treatment and prevention of atrial fibrillation. The purpose of this review is to discuss some aspects of the scientific basis, current standards and possible future research related to cardiac pacing for prevention of atrial fibrillation. Trials involving pacing at the alternative pacing site per se or in combination with specific algorithms for prevention of atrial fibrillation have not shown consistent results. Recently, a new generation of antitachycardia pacing therapies has brought on a new optimism with promising outcome data of reduction in permanent atrial fibrillation, cardiovascular hospitalizations, and mortality. Multiple trials and clinical observational studies of different pacing methods and algorithms, with the exception of newer therapies in conjunction with atrial pacing algorithms, have not been shown to prevent atrial fibrillation. Hence, while permanent pacing is indicated for sinus node dysfunction and conduction abnormalities in patients with or without atrial fibrillation, the prevailing data in the literature does not support implantation of a permanent pacemaker for prevention of atrial fibrillation per se.

Indian Heart Journal

Left ventricular end-diastolic volume (preload), peak systolic wall stress (afterload), instant E... more Left ventricular end-diastolic volume (preload), peak systolic wall stress (afterload), instant Emax (contractility index = peak systolic left ventricular pressure/end-systolic volume), left ventricular mass, left ventricular ejection fraction (LVEF) alone and normalised for mass index, were studied in 30 patients with isolated rheumatic mitral stenosis (group 1) and compared with 24 normal individuals (group II) who served as control. Preload was not different in the two groups (p = NS), afterload was increased in group I (p = 0.01), while LVEF, Emax, left ventricular mass and mass normalised LVEF were reduced in mitral stenosis as compared to normal control (p less than 0.01- less than 0.001). Comparison of patients with reduced ejection performance (LVEF less than 50%, n = 9, group IA) with those having normal LVEF (n = 21 group IB) revealed increased left ventricular end-diastolic volume and reduced left ventricular mass, mass normalised ejection fraction and Emax (in IA p less than 0.05). Peak systolic wall stress was comparable in these two subgroups. This study shows that the major determinant of left ventricular dysfunction in isolated rheumatic mitral stenosis is impaired contractility and not the loading factors.

The Journal of the Association of Physicians of India, 1989

The converting enzyme inhibitor, captopril, in dose of 75-100 mg/day with or without diuretic was... more The converting enzyme inhibitor, captopril, in dose of 75-100 mg/day with or without diuretic was given to 40 patients (18 males, 22 females), mean age 47.5 years with moderate to severe essential hypertension. Sustained control of blood pressure was achieved in all except three patients on follow up of 12 weeks. Adverse side effects included temporary taste disturbance, rash, tachycardia, leucopaenia, nausea and transient albuminuria. No effect on electrolyte mileu was observed. First dose hypotensive or triphasic response was not noted in any patient. Our results suggest that captopril in moderate doses is very safe, acceptable and effective drug with minimal side effects for treatment of moderate to severe essential hypertension on out patient basis.

Indian heart journal

Ten patients of dominant right ventricular dilated cardiomyopathy (RVDCM) seen over a period of t... more Ten patients of dominant right ventricular dilated cardiomyopathy (RVDCM) seen over a period of three years in this institution are described. There were six males and four females in the age range of 6.50 years. Presenting features were right ventricular failure (7), paroxysmal supraventricular tachycardia (2), and one patient was detected on routine chest skiagram. All patients had characteristic electrocardiographic and radiologic features. 2D-echocardiographic examination revealed enormous dilatation of right atrium, ventricular cavity and outflow tract, interatrium and ventricular septum concave to the right, pre-systolic pulmonary valve opening, small left atrium and ventricle. Pulsed doppler echocardiogram revealed varying degree of tricuspid incompetence in all. Four patients underwent haemodynamic and cineangiographic studies showing left ventricular involvement in one. The patients have been followed up on digitalis, diuretics and quinidine with variable response to treatm...

Journal of Interventional Cardiac Electrophysiology, 2014

Indian Heart Journal, 2014