Tarlochan Singh Kler | |
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Born | |
Occupation(s) | Interventional cardiologist Medical writer |
Known for | Interventional cardiology |
Awards | Padma Bhushan |
Tarlochan Singh Kler is an Indian interventional cardiologist, medical administrator, writer, Chairman at Fortis Heart and Vascular Institute, (Fortis Memorial Research Institute,Gurugram and Fortis Flt. Lt. Rajan Dhall Hospital) and (former Director of Cardiac Sciences at Fortis Escorts Heart Institute). [1] Born in Amargarh in the Indian state of Punjab, [2] he graduated in medicine from Punjabi University in 1976, secured his MD in general medicine from Postgraduate Institute of Medical Education and Research (PGIMER) in 1980 and followed it up with the degree of DM in cardiology from the same institution in 1983. [3] He succeeded Naresh Trehan as the executive director of Fortis Heart Institute and Research Centre before becoming its director. [4] He has written several articles on interventional cardiology; Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular pacemaker implantation, [5] Mammary coronary artery anastomosis without cardiopulmonary bypass through minithoracotomy: one year clinical experience, [6] and Ventricular Fibrillation in the EP Lab. What is the Atrial Rhythm? [7] are some of the notable ones. The Government of India awarded him the third highest civilian honour of the Padma Bhushan, in 2005, for his contributions to medicine. [8]
Bradycardia is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, and in athletes.
An artificial cardiac pacemaker or artificial pacemaker, and sometimes just pacemaker—although the term is also used to refer to the body's natural cardiac pacemaker—is a medical device, nowadays always implanted, that generates electrical pulses delivered by electrodes to the chambers of the heart, either the upper atria or lower ventricles. Each pulse causes the targeted chambers to contract and pump blood, thus regulating the function of the electrical conduction system of the heart.
Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle, restoring the activity of the electrical conduction system of the heart. Pharmacologic cardioversion, also called chemical cardioversion, uses antiarrhythmia medication instead of an electrical shock.
Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and oxygen to the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment.
The sinoatrial node is an oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of cells known as pacemaker cells. The sinus node is approximately 15 mm long, 3 mm wide, and 1 mm thick, located directly below and to the side of the superior vena cava.
Atrial flutter (AFL) is a common abnormal heart rhythm that starts in the atrial chambers of the heart. When it first occurs, it is usually associated with a fast heart rate and is classified as a type of supraventricular tachycardia. Atrial flutter is characterized by a sudden-onset (usually) regular abnormal heart rhythm on an electrocardiogram (ECG) in which the heart rate is fast. Symptoms may include a feeling of the heart beating too fast, too hard, or skipping beats, chest discomfort, difficulty breathing, a feeling as if one's stomach has dropped, a feeling of being light-headed, or loss of consciousness.
Third-degree atrioventricular block is a medical condition in which the electrical impulse generated in the sinoatrial node in the atrium of the heart can not propagate to the ventricles.
The jugular veins are veins that take deoxygenated blood from the head back to the heart via the superior vena cava. The internal jugular vein descends next to the internal carotid artery and continues posteriorly to the sternocleidomastoid muscle.
The atrium is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves.
In the heart's conduction system, Bachmann's bundle is a branch of the anterior internodal tract that resides on the inner wall of the left atrium. It is a broad band of cardiac muscle that passes from the right atrium, between the superior vena cava and the ascending aorta. Bachmann's bundle is, during normal sinus rhythm, the preferential path for electrical activation of the left atrium. It is therefore considered to be part of the "atrial conduction system" of the heart.
The sinoatrial nodal artery is an artery of the heart which supplies the sinoatrial node, the natural pacemaker center of the heart. It is usually a branch of the right coronary artery. It passes betweeen the right atrium, and the opening of the superior vena cava.
Dronedarone, sold under the brand name Multaq, is a medication by Sanofi-Aventis, mainly for the indication of cardiac arrhythmias. It was approved by the FDA on July 2, 2009. It was recommended as an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment i.e. direct current cardioversion (DCCV) to maintain normal rhythm. It is a class III antiarrhythmic drug. In the United States, the FDA approved label includes a claim for reducing hospitalization, but not for reducing mortality, as a reduction in mortality was not demonstrated in the clinical development program. A trial of the drug in heart failure was stopped as an interim analysis showed a possible increase in heart failure deaths, in patients with moderate to severe CHF.
An ectopic pacemaker, also known as ectopic focus or ectopic foci, is an excitable group of cells that causes a premature heart beat outside the normally functioning SA node of the heart. It is thus a cardiac pacemaker that is ectopic, producing an ectopic beat. Acute occurrence is usually non-life-threatening, but chronic occurrence can progress into tachycardia, bradycardia or ventricular fibrillation. In a normal heart beat rhythm, the SA node usually suppresses the ectopic pacemaker activity due to the higher impulse rate of the SA node. However, in the instance of either a malfunctioning SA node or an ectopic focus bearing an intrinsic rate superior to SA node rate, ectopic pacemaker activity may take over the natural heart rhythm. This phenomenon is called an escape rhythm, the lower rhythm having escaped from the dominance of the upper rhythm. As a rule, premature ectopic beats indicate increased myocyte or conducting tissue excitability, whereas late ectopic beats indicate proximal pacemaker or conduction failure with an escape 'ectopic' beat.
The following outline is provided as an overview of and topical guide to cardiology, the branch of medicine dealing with disorders of the human heart. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in cardiology are called cardiologists.
Landiolol (INN) is an ultra short-acting, β1-superselective intravenous adrenergic antagonist, which decreases the heart rate effectively with less negative effect on blood pressure or myocardial contractility. In comparison to other beta blockers, landiolol has the shortest elimination half-life, ultra-rapid onset of effect, and predictable effectiveness with inactive metabolites. The pure S-enantiomer structure of landiolol is believed to develop less hypotensive side effects in comparison to other β-blockers. This has a positive impact on the treatment of patients when reduction of heart rate without decrease in arterial blood pressure is desired. Landiolol was developed by modifying the chemical structure of esmolol to produce a compound with a higher rate of cardioselectivity and a greater potency without increasing its duration of action. It is sold as landiolol hydrochloride. Based on its positive benefit risk profile, landiolol has been granted the marketing authorization and introduced to the European markets under the brand names Rapibloc, Raploc, Runrapiq, Landibloc mid 2016. Landiolol is available in Japan under the brand names Onoact (50 mg) and Corbeta.
Cardiac resynchronisation therapy is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the anterior chest wall.
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death.
Rhythm interpretation is an important part of healthcare in Emergency Medical Services (EMS). Trained medical personnel can determine different treatment options based on the cardiac rhythm of a patient. There are many common heart rhythms that are part of a few different categories, sinus arrhythmia, atrial arrhythmia, ventricular arrhythmia. Rhythms can be evaluated by measuring a few key components of a rhythm strip, the PQRST sequence, which represents one cardiac cycle, the ventricular rate, which is the rate at which the ventricles contract, and the atrial rate, which is the rate at which the atria contract.
Günter Breithardt is a German physician, cardiologist and emeritus university professor. He is known for his research in the field of rhythmology, especially the diagnosis and pharmacological and non-pharmacological therapy of cardiac arrhythmias and acute cardiac death, in particular the identification of arrhythmia-triggering gene mutations. For 21 years he headed the Medical Clinic and Polyclinic C at Münster University Hospital. A number of his academic students hold university management and chief physician positions.
Raghib syndrome is rare a congenital heart defect where the left superior vena cava (LSVC) is draining into the left atrium in addition to an absent coronary sinus and an atrial septal defect. This can be considered a dangerous heart condition because it puts the individual at a high risk of stroke. Other defects that are often associated with Raghib syndrome can include ventricular septal defects, enlargement of the tricuspid annulus, and pulmonary stenosis. While this is considered an extremely rare developmental complex, cases regarding a persistent left superior vena cava (PLSVC) are relatively common among congenital heart defects. It is also important to note that the PLSVC often drains into the right atrium, and only drains into the left atrium in approximately 10 to 20% of individuals with the defect.
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