Maneesh K Rai

Manipal Academy of Higher Education | MAHE · Department of Cardiology

Non-Hodgkin’s lymphoma presenting as a primary cardiac lymphoma (PCL) is extremely unusual. Having a predilection for the right side of the heart and accounting for 1% of all cardiac tumours, the difficulty in diagnosing the lesion, owing to the location and vague presenting symptoms and signs, often leads to delayed diagnosis and poor prognosis. I...

Background There is a high incidence of atrial fibrillation (AF) in patients with isolated rheumatic mitral regurgitation (MR). The histopathologic changes in the atria of patients with isolated rheumatic MR with and without AF are unknown. Objectives We aimed to determinethe histological findings in patients with isolated severe rheumatic MR with...

Background Conduction system pacing prevents pacing-induced cardiomyopathy, but it can be challenging to perform in patients with congenital heart disease (CHD), and mid/high septal lead implantation is an alternative. This study aimed to assess intraprocedural angiography's utility as a guide for mid/high-septal lead implantation in CHD patients....

Background Right ventricular (RV) mid-septal pacing has been proposed as an alternative to RV apical pacing. Fluoroscopic and electrocardiogram criteria are unreliable for predicting the RV mid-septal lead position. This study aimed to define the optimal RV mid-septal pacing site using RV angiography. Methods We randomized patients undergoing pace...

Background Risk stratification in Brugada syndrome remains a controversial and unresolved clinical problem, especially in asymptomatic patients with a type 1 ECG pattern. The purpose of this study is to derive and validate a prediction model based on clinical and ECG parameters to effectively identify patients with a type 1 ECG pattern who are at h...

Background Andersen Tawil Syndrome (ATS) is a rare familial periodic paralysis that typically also affects the heart and skeletal system. Ventricular arrhythmias (VA) are profound, difficult to control but minimally symptomatic. In this report we describe an atypical phenotype of ATS in 2 related families. We also report our experience with phenyto...

Transvenous pacing in patients with postoperative complex congenital heart disease (CHD) can be challenging and pose technical challenges to lead placement because of the complex anatomy, distortions produced by the surgical procedures, and the altered relationship of cardiac chambers. We describe the utility of angiography for transvenous dual cha...

Background Cardiac involvement in children with Kawasaki disease (KD) may present with repolarization abnormalities which are associated with increased risk of ventricular arrhythmias and sudden cardiac events. Methods Twenty children with history of KD without cardiac involvement in the acute phase were recruited along with age and sex-matched co...

Background Purkinje Fibre mediated Arrhythmias in the setting of Acute Myocardial Infarction are poorly responsive to conventional anti‐arrhythmic therapy, increases overall mortality and often requires Radiofrequency ablation (RFA) for control. In this study we report the use of intravenous Fosphenytoin for the control of arrhythmic storm in patie...

Long QT syndrome patients can present as second-degree AV block due to prolongation of refractory period. We report a case of pseudo 2:1 AV block due to long QT syndrome in which treatment differs from conventional second-degree AV block because of uncommon presentation and poor prognosis with no consensus.

Background and Objectives We analyzed Lead II in patients undergoing an Oral Flecainide Challenge test (FCT), to identify any pointers that could predict a positive FCT and thereby help in recognition of latent BS. Methods The following parameters in lead II were retrospectively analyzed from the pre-test ECG in 62 patients undergoing FCT for susp...

Background Cardiac Resynchronization therapy (CRT) remains largely under-used in developing countries owing to the high cost of therapy. In this pilot study, we explore ‘optimized’ Left Ventricle Only Pacing (LVOP) as a cost effective alternative to cardiac resynchronization therapy in selected patients with heart failure. Hypothesis In economical...

Background: Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives: To analyze the histological changes associated with isolated MS and compare between chan...

A 35 year old male, known case of corrected transposition of great arteries presented with exertional dyspnoea and recurrent pre-syncope. 12 lead electrocardiogram revealed a regular rhythm at 75 beats per minute, P waves occurring on the upstroke of T waves and apparent 1:1 P-QRS relationship. The possibilities to be considered - complete AV block...

Prolonged Tpeak-end and Tpeak-end / QT ratio have been shown to be markers of arrhythmogenesis in various cardiac disorders. To evaluate the utility of Tpeak-end , and Tpeak-end / QT ratio at admission in acute ST elevation MI (STEMI) to predict malignant ventricular arrhythmias. The study group included fifty patients presenting with STEMI in whom...

Complex congenital heart diseases involving abnormalities of the atrial situs and cardiac malpositions like dextrocardia can pose a considerable challenge to transvenous permanent pacemaker implantation (PPI). Literature describing transvenous PPI techniques in patients with complex cardiac anomalies is scarce. In this report, we describe a novel a...

The Riata and Riata ST family of implantable cardioverter-defibrillator leads are prone to a unique type of structural failure involving exteriorization of the conductor cables, which may present as electrical failure. We report a mode of lead failure that occurred in a patient with a Riata 1570 series dual coil 8F lead. In this case, the first app...

Aims Dextrocardia is a rare congenital anomaly. Pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy and associated anomalies. The literature regarding implantation of pacemaker in dextrocardia is scarce. Methods and results The study involved retrospective analysis of records of patients with dextrocardia who...

Wide QRS tachycardia can pose a diagnostic dilemma, and a number of electrocardiographic criteria have been proposed to differentiate ventricular tachycardia from supraventricular tachycardia with aberrancy.This article is protected by copyright. All rights reserved.

Sinus of Valsalva aneurysms are commonly associated with ventricular septal defects. We describe a 14 year old boy who presented with Rupture of Right Sinus Of Valsalva (RSOV) into the right ventricular outflow tract (through two openings) along with a residual ventricular septal defect (VSD), four years after surgical closure of the VSD. Both ante...

Background: Isolated interruption of the inferior vena cava (IVC) is a rare anomaly. We report a series of 4 cases of isolated interruption of the IVC that coexisted with rheumatic mitral stenosis. Interrupted IVC precludes the use of the femoral approach to percutaneous transseptal mitral commissurotomy (PTMC). We describe the jugular approach to...

Multifocal and bilateral involvement of the arch vessels is a common presentation of Takayasu's arteritis. Endovascular stenting of multiple supra aortic lesions in Takayasu's arteritis has been described scarcely in literature. We describe the management of a case of Takayasu's arteritis who presented with recurrent vertebro-basilar symptoms and a...