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7%) patients. Around 40% patients had recanalized/non obstructive/thrombotic/normal coronaries on coronary angiogram.

Conventional risk factors such as smoking, low HDL levels and abdominal obesity play a major role in the causation of premature coronary artery disease among the rural youth. Thrombotic milieu in the coronaries was commonly noted in coronary angiograms. Lack of awareness, combined with urbanisation of rural lifestyle could be responsible for increasing incidence of premature coronary artery disease in rural youth.

Conventional risk factors such as smoking, low HDL levels and abdominal obesity play a major role in the causation of premature coronary artery disease among the rural youth. Thrombotic milieu in the coronaries was commonly noted in coronary angiograms. Lack of awareness, combined with urbanisation of rural lifestyle could be responsible for increasing incidence of premature coronary artery disease in rural youth.

While the pro-inflammatory and pro-coagulant effects of cigarette smoking have been well described, the effect of smokeless tobacco (ST) on inflammatory and coagulation markers is still not clear. The study aimed to evaluate impact of smokeless tobacco use on systemic markers of inflammation [(TLC), neutrophil-lymphocyte ratio (NLR) (ESR), interleukin (IL) IL-1β, IL-6 and tumor necrosis factor alpha (TNFα)] and hypercoagulable state [fibrinogen and d-dimer] leading to increased cardiovascular risk in ST users as compared to non-users.

150 healthy young adults using oral tobacco products for at least 1 year were included in the case group and 50 age-matched non-consumers as controls. Subjects with any known chronic illness or comorbidity were excluded from the study. Blood samples were tested for TLC, NLR, ESR, IL-1β, IL-6, TNFα, fibrinogen and d-dimer. Statistical analysis was done using SPSS 17.0 software.

The baseline clinical and cardio-metabolic characteristics were comparable between the two groups. ST users had significantly elevated serum IL-6 [59.29±124.69pg/mL (n=149) vs 8.21±27.27pg/mL (n=47), p-value=0.005], TNFα [77.18±236.10pg/mL (n=149) vs 8.32±9.36pg/mL (n=47), p-value=0.041], fibrinogen [310.53±129.05mg/dL (n=143) vs 282.82±65.23mg/dL (n=42), p-value=0.045] and d-dimer [0.28±0.42mg/L (n=144) vs 0.17±0.09mg/L (n=45), p-value=0.043] levels as compared to non-users. Serum TLC, NLR, ESR and IL-1β remained unchanged in ST users and were similar to that of controls.

Chronic use of ST is associated with systemic inflammation and coagulation, which may increase the risk of athero-thrombotic cardiovascular events among ST users.

Chronic use of ST is associated with systemic inflammation and coagulation, which may increase the risk of athero-thrombotic cardiovascular events among ST users.

Achievement of sinus rhythm (SR) is an important goal in rheumatic atrial fibrillation (AF). Studies in rheumatic AF have often used amiodarone for rhythm control. Flecainide has not been studied in these patients due to concerns of underlying structural heart disease.

Pharmacological cardioversion by oral single loading dose (SLD) of Flecainide (4mg/kg, ≤300mg) was tested in 50 patients with rheumatic AF (MVA 1.51±0.19mm

, age 46.2±10.28yrs, AF duration 3.10±1.7yrs, LA size 44.42±7.48mm). Non-converters underwent DC cardioversion (DCC) at 24h. All patients received oral flecainide and ββ/diltiazem at discharge.

At 24h, 38/50 (76%) achieved SR (2 with SLD; 36 after DCC). At 30 days (mean Flecainide dose 116.5±10.5mg) successful maintenance of SR was noted in 31/38 (89%). At 1 year, 30/38 (79%) of the initial converters and 60% of the overall population maintained SR. Those in SR had significantly better NYHA Class (1.1±0.12 vs 1.3±0.10, p=0.03) and mean PCS8 score (50.11±5.337 vs 46.84±5.379, p=0.02). AF duration (OR 0.594 CI 0.375-0.940, p=0.02) and LA size (OR 0.840, CI 0.757-0.933, p=0.001) were found to be the only significant predictors of successful outcomes. Patients with AF duration <3.5 years and LA size <51mm had 85% and 75% chance of maintaining SR at 1 year, respectively.

Flecainide is safe and effective for achieving and maintaining SR in patients of rheumatic AF who are unlikely to have underlying coronary artery disease or ventricular dysfunction.

Flecainide is safe and effective for achieving and maintaining SR in patients of rheumatic AF who are unlikely to have underlying coronary artery disease or ventricular dysfunction.

In this study we report our experience in implanting MICRA TPS (transcatheter pacing system) at various RV sites; observing its safety, and impact on paced QRS in Indian population.

35 patients with MICRA TPS deployed from March 2017 to December 2019 at Army Hospital Research and Referral, New Delhi, at RVOT, apical septum and mid septum of RV were enrolled in the study. These patents were followed up and impact of implantation site, procedure related complications, change in pacing parameters, left ventricular ejection fraction and duration of paced QRS were monitored.

Sick sinus syndrome was the commonest indication of pacing in this study (51.5%), followed by high degree AV block (34.2%). Mean follow up of 1.4 years showed no change in left ventricular ejection fraction, electrical parameters or change in pacing thresholds after implantation. Mean pQRS was broadest (166.60ms) in apically implanted MICRA TPS and narrowest in mid septum group 139.33ms. Among 35 cases, in our study one patient developed pericardial effusion, and other had intermittent diaphragmatic pacing.

Among these three implantation sites mid septum deployment is associated with narrowest paced QRS in Indian population.

Among these three implantation sites mid septum deployment is associated with narrowest paced QRS in Indian population.

Left atrial appendage occlusion (LAAO) in non-valvar atrial fibrillation (AF) reduces cardioembolic strokes. Despite increased risk, trials exclude valvar AF in structural heart diseases where clots extend beyond appendage.

Patients with AF and relative risks for oral anticoagulation (OAC) needing structural interventions underwent concomitant LAAO. After six months of OAC, aspirin was continued. Transesophageal echocardiogram was done three monthly till one year and yearly thereafter. The patient demographics, procedural details, post-procedural follow-up were analyzed.

Nine patients aged 51.5±6.3 years with AF underwent LAAO concomitantly with balloon mitral valvotomy in four patients, atrial septal defect device closure in four and periprosthetic mitral leak closure in one patient. Six patients had heart failure, four had prior embolic events, and two had documented LAA thrombus. The mean CHADS

VASc score was 2.44±0.8 and mean HASBLED score was 3.0±0.8. Devices included Amplatzer Cardiac Plug™ in siarly thrombus formation indicates immunity from clot formation after device endothelialisation. Larger multicenter trials combining LAAO with structural interventions in valvular AF are warranted in developing nations.

The role of late gadolinium enhancement (LGE) in cardiac MRI (CMR) as prognostic marker in non-ischemic dilated cardiomyopathy (NIDCM) is evolving.

To study the effect of LGE in the prognosis of NIDCM patients.

112 consecutive NIDCM patients, who underwent CMR, were prospectively followed up for 745±320 days. Primary end point was occurrence of MACE composite of all-cause mortality, resuscitated cardiac arrest, sustained ventricular tachycardia (VT)/appropriate ICD shock, heart failure (HF) hospitalization.

LGE was present in 44 out of 112 patients (39%). The primary end point (MACE) was significantly higher in LGE+ve group compared to the LGE -ve group (72.7% vs. 29.4%; p<0.0001). Similarly, cardiac mortality (9.1% vs 2.9%; p<0.049), VT (13.6% vs. 2.9%; p<0.031), HF hospitalization (63.6% vs. 30.9%; p<0.001) were significantly more in LGE+ve group. In univariate model, LGE demonstrated the strongest association with MACE (Hazard ratio [HR]=2.96 [95% CI 1.685 to 5.201; p<0.0001). LGE extent of >14% of LV predicted MACE with 90.6% sensitivity and 86% specificity. HR of LGE extent >14% of LV for MACE is 6.12; p<0.01. LGE was associated with MACE irrespective of its location, pattern or distribution. Multivariate model showed LGE and its extent >14% of LV volume were strongest predictor of MACE.

LGE and its extent >14% predicts adverse cardiac events in NIDCM irrespective of LVEF and LGE location, pattern or distribution. This study emphasises the role of CMR in risk stratification of NIDCM patients and guiding therapy.

14% predicts adverse cardiac events in NIDCM irrespective of LVEF and LGE location, pattern or distribution. This study emphasises the role of CMR in risk stratification of NIDCM patients and guiding therapy.

Acute kidney injury (AKI) frequently co-prevails with acute coronary syndromes (ACS), which could improve post percutaneous coronary intervention (PCI). We sought to evaluate the impact of PCI on post-procedural renal function in patients with impaired baseline serum creatinine (Cr).

Retrospective evaluation of 185 patients undergoing PCI with impaired basal serum Cr (≥ 1.5mg/dl) was done, including 88 (47.5%) patients with recent ACS (≤2 weeks old) in group I and 97 (52.4%) patients in group II (stable angina or ACS >2 weeks old). Patients were classified into worsening or improving renal function based on a corresponding increase or decrease of ≥0.5mg/dl (ΔCr) in serum Cr 24-48h post PCI. ΔCr<0.5mg/dl was termed as no change.

A trend towards improving renal function was seen in the study cohort (mean serum Cr 2.37±1.25mg/dl vs 2.28±1.59mg/dl); (p=0.09) with decrease in group I from 2.28±1.09mg/dl to 2.12±1.44mg/dl (p=0.03) and in group II from 2.45±1.38mg/dl to 2.43±1.71mg/dl (p=0.81). Post PCI, worsening occurred in 20/185 (10.8%) patients in the total study cohort, 5/88 (5.6%) in group I and 15/97 (15.4%) in group II (p=0.03). Improvement in serum Cr was seen in 49/185 (26.4%) in the total study cohort, 30/88 (34.1%) in group I and 19/97 (19.6%) patients in group II (p=0.03).

- Post PCI, only a small proportion of patients with impaired baseline creatinine showed worsening in renal function. Improved renal function was observed in at least one-third of the patients with recent ACS.

- Post PCI, only a small proportion of patients with impaired baseline creatinine showed worsening in renal function. learn more Improved renal function was observed in at least one-third of the patients with recent ACS.

The National interventional Council of Cardiological Society of India (CSI-NIC) is the society representing all the practising interventional cardiologists across country. Every year National interventional council collects the data of coronary and non-coronary interventions across all the cath labs in the country and data will be presented at annual meet. This Data will show the burden of disease, number of interventions and adaption of various newer procedures from various centers across India.

Retrospective collection of data pertaining to all the coronary and non coronary interventions across India for the period of 1 year from January 1 st 2018 to December 31 st 2018. This data was collected by various methods like online submission, email based collection of data and filled proforma from all working cath labs all over the country. All the data was compiled and analysed for various interventional procedures.

A total of 4,38,351 percutaneous interventions were performed in 1 year period during 2018 and utilized 5,78,164 coronary stents with a 13.