Ventricular fibrillation (VF) is the most serious variety of arrhythmia which requires quick and accurate detection to save lives. In this paper, we propose a new time domain algorithm, called threshold crossing sample count (TCSC), which is an improved version of the threshold crossing interval (TCI) algorithm for VF detection. The algorithm is based on an important feature of the VF signal which relies on the random behavior of the electrical heart vector. By two simple operations: comparison and count, the technique calculates an effective measure which is used to separate lifethreatening VF from other heart rhythms. For assessment of the performance of the algorithm, the method is applied on the complete MIT-BIH arrhythmia and CU databases, and a promising good performance is observed. Seven other classical and new VF detection algorithms, including TCI, have been simulated and comparative performance results in terms of different quality parameters are presented. The TCSC algorithm yields the highest value of the area under the receiver operating characteristic curve (AUC). The new algorithm shows strong potential to be applied in clinical applications for faster and accurate detection of VF.

BackgroundTo determine whether waist-to-height ratio correlates with coronary artery disease (CAD) severity better, than the body mass index (BMI) as assessed by coronary angiography in Bangladeshi population.MethodsThis cross sectional study was done on patients in Department of Cardiology in DMCH and those referred in the cath-lab of the Department of Cardiology for CAG during November 2009 to October 2010 involving 120 patients. They were divided into group-A (with coronary score ≥7) and group-B (coronary score <7) depending on Gensisni score.ResultThere were no statistically significant difference regarding the distribution of age, sex and clinical diagnosis and parameters between the two groups. The mean age of patients was 51.7 ± 8.2 years and 48.8 ± 9.1 years in Group A and Group B respectively with a male predominance in both the groups. Patients in group A had higher BMI ≥25 and waist to height ratio (≥0.55) than Group B which showed a statistically significant association (p < 0.001). Though a significant positive correlation (r = 0.296, p = 0.006) was observed between BMI and Coronary artery disease score in group A patients, scenario was reverse fro group B (r = 0.076, p = 0.659). The statement was also true for Waist-to-height ratio and Waist-to-height ratio with BMI. Multivariate analysis also yeilded that a patient with BMI ≥25 kg/m2 and waist-to height ratio of ≥0.55 are 3.06 times and 6.77 times, more likely to develop significant coronary artery disease respectively.ConclusionThe waist-to-height ratio showed better correlation with the severity of coronary artery disease than the BMI.

Acute coronary syndrome (ACS) remains the leading cause of death in the developed world and second leading cause of death in developing countries. Elevated troponin levels and extent of ST-segment depressions are clinically important because they may act as an effective prognostic marker .This cross-sectional study has been designed to see the correlation of ST-segment depression and level of troponin I with in-hospital outcome of NSTEMI patients. The study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011- March, 2012. A total of 90 patients were selected by purposive sampling. In this study,the mean ±SD age of the patients was 55.9±9.1 years with a range of 36-80 years with a male -female ratio of 2:1.Over all dyslipidaemia was the most common risk factor present in 55(61.10%) patients followed by smoking in 48(53.3%) patients then obesity in 32(35.60%) then hypertension in 31(34.4%) patients. Troponin I level was significantly high in patients who developed acute LVF (10.36±7.4 vs 7.0124±6.8, p=.027), and cardiogenic shock (13.72±11.37 vs 8.64±7.35, p=.033). Troponin I was significantly high in patients who developed complication (10.72±8.84 vs 6.24±5.41, p=.005) than the patients who were discharged without complication. ST segment depression was significantly more in patients who developed acute LVF(1.07±1.63 vs.55±.74, p=.048). Logistic regression analysis of acute LVF with Troponin I and ST-segment depression showed that ST-segment depression and level of Troponin I were important correlates of acute LVF .Medicine Today 2015 Vol.27(2): 14-19

Aims: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Dhaka Medical College Hospital, Dhaka. Materials and Methods: A total of 800 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease at DMCH, Dhaka, Bangladesh. Results: Mean age of presentation was 51.27±8.80 years. Majority were male 628 (78.5%) and rest were females (21.5%). Most patients had ST elevated myocardial infarction (STEMI) 509 (63.6%) followed by non-STEMI (NSTEMI) 207 (25.9%) and Unstable Angina (UA) 84 (10.5%). Risk factors: smoking was present in 388 (48.5%), hypertension in 289 (36.13%), diabetes in 235 (29.38%), dyslipidaemia in 169 (21.13%) and obesity in 356 (44.5%) patients. Singlevessel disease was present in 30.32% patients, Doublevessel disease was present in 23.23% patients and Triple vessel disease was present in 27.15% patients. Conclusion: STEMI was the most common presentation. ACS occurred earlier in comparison to Western population. Smoking was most prevalent risk factor. Diabetic patients had more multivessel disease.

Abstract:Background: Heart failure is a complex clinical syndrome that arises secondary to abnormalities of cardiac structure and/or function (inherited or acquired)

Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD) is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS), no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH) from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female). Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032) and conduction defect (13.0% vs 1.4%, p=0.017) than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%). The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010). Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS. DOI: http://dx.doi.org/10.3329/jemc.v5i1.21492 J Enam Med Col 2015; 5(1): 15-22

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Background: Epidemiological transition which is taking place in every part of the world, among all races, ethnic groups and cultures has resulted in the global rise in cardiovascular disease (CVD). Cardiovascular disease is the leading cause of morbidity and mortality throughout the world. We tried to assess the pattern of cardiac disease at coronary care unit (CCU) of tertiary care hospital. Methods: A cross sectional study conducted among the patients admitted at CCU of Dhaka Medical College Hospital (DMCH) during the period of 1st January 2010 to 31st December 2010. A total of 2415 patients were included in the study. Results: A total 2415 patients in the year 2010, were admitted at CCU of DMCH, among them 56% (n=1346) were male and 44% (n=1069) were female. Out of total admitted patients 220 (9%) were below 30 years of age and 588 ( 24%) & 1607 (67 %) were the age group of 31 to 44 years and 45 years and above age group respectively. Among the disease group ischemic heart disease( IHD) (45%) was the most common cause of hospitalization followed by heart failure (HF) (16%) valvular heart disease (9%), hypertension (7%) and arrhythmia (2%). Acute myocardial infarction (30 %) was the leading cause of IHD followed by unstable angina (15%). Conclusion: This study has found that almost three-quarters of cardiac disease were due to IHD, HF and valvular heart disease in decreasing order of frequency. Countries like Bangladesh can be able to spend very little resources to address those cardiovascular diseases. Along with public as well as private sector efforts, public awareness about the risk factors for cardiovascular diseases should be improved to reduce this sort mortality and morbidity. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22259 Cardiovasc. j. 2015; 7(2): 119-122