The study was supported by Novartis.

AI-guided ablation is associated with significant improvements in the incidence of acute PV reconnection and atrial tachyarrhythmia recurrence rate compared to CF-guided ablation, potentially due to creation of better quality lesions as suggested by greater impedance drop.

The inverse graded relationship of education and risk factors of coronary heart disease (CHD) has been reported from Western populations. To examine whether risk factors of CHD are predicted by level of education and influenced by the level of urbanization in Indian industrial populations, a cross-sectional survey (n ‫؍‬ 19,973; response rate, 87.6%) was carried out among employees and their family members in 10 medium-to-large industries in highly urban, urban, and periurban regions of India. Information on behavioral, clinical, and biochemical risk factors of CHD was obtained through standardized instruments, and educational status was assessed in terms of the highest educational level attained. Data from 19,969 individuals were used for analysis. Tobacco use and hypertension were significantly more prevalent in the low-(56.6% and 33.8%, respectively) compared with the higheducation group (12.5% and 22.7%, respectively; P < 0.001). However, dyslipidemia prevalence was significantly higher in the high-education group (27.1% as compared with 16.9% in the lowest-education group; P < 0.01). When stratified by the level of urbanization, industrial populations located in highly urbanized centers were observed to have an inverse graded relationship (i.e., higher-education groups had lower prevalence) for tobacco use, hypertension, diabetes, and overweight, whereas in less-urbanized locations, we found such a relationship only for tobacco use and hypertension. This study indicates the growing vulnerability of lower socioeconomic groups to CHD. Preventive strategies to reduce major CHD risk factors should focus on effectively addressing these social disparities.coronary heart disease ͉ socioeconomic status B ecause cardiovascular disease has become the leading cause of mortality worldwide, coronary heart disease (CHD) is now contributing to large and rising burdens of death and disability in many developing countries (1). The relationship of socioeconomic status (SES) and CHD has varied across different populations, when concurrently studied, and within each population, when studied over time (2). In populations where the CHD epidemic has matured over several decades, it has been observed that the epidemic of CHD appears to emerge first in higher socioeconomic groups and declines first in the same groups (3, 4). Studies conducted in developed countries over the past three decades provide convincing evidence of an inverse relationship between SES and CHD (5-9). Additionally, the lowest socioeconomic group is reported to have increased prevalence of subclinical CHD compared with those in the highest socioeconomic group (10, 11). However, when multiple countries are compared, the relationship is quite variable, depending on the level of health transition in each country. It has been suggested that studies of CHD risk factors in heterogeneous populations of developing countries may help us understand the multifactorial nature of CHD causation (2).In India, a large developing country, the relationship of SES to CHD has not ...

Objective To establish a surveillance network for cardiovascular diseases (CVD) risk factors in industrial settings and estimate the risk factor burden using standardized tools. Methods We conducted a baseline cross-sectional survey (as part of a CVD surveillance programme) of industrial populations from 10 companies across India, situated in close proximity to medical colleges that served as study centres. The study subjects were employees (selected by age and sex stratified random sampling) and their family members. Information on behavioural, clinical and biochemical determinants was obtained through standardized methods (questionnaires, clinical measurements and biochemical analysis). Data collation and analyses were done at the national coordinating centre. Findings We report the prevalence of CVD risk factors among individuals aged 20-69 years (n = 19 973 for the questionnaire survey, n = 10 442 for biochemical investigations); mean age was 40 years. The overall prevalence of most risk factors was high, with 50.9% of men and 51.9% of women being overweight, central obesity was observed among 30.9% of men and 32.8% of women, and 40.2% of men and 14.9% of women reported current tobacco use. Self-reported prevalence of diabetes (5.3%) and hypertension (10.9%) was lower than when measured clinically and biochemically (10.1% and 27.7%, respectively). There was marked heterogeneity in the prevalence of risk factors among the study centres. Conclusion There is a high burden of CVD risk factors among industrial populations across India. The surveillance system can be used as a model for replication in India as well as other developing countries. Voir page 467 le résumé en français. En la página 468 figura un resumen en español. IntroductionCardiovascular diseases (CVDs are maj j jor contributors to the global burden of chronic diseases with 29.3% of global deaths and 9.9% of total disease burden, in terms of disabilityjadjusted life years (DALYs) lost, being reported in 2003. 4 Major causes for the inj j crease in disease burden are rising rates of hypertension, dyslipidaemia, diabetes, overweight, obesity, physical inactivity and tobacco use. 5In India, CVD is projected to be the largest cause of death and disabilj j ity by 2020, 5 with 2.6 million Indians predicted to die due to coronary heart disease, which constitutes 54.1% of all CVD deaths. Nearly half of these deaths are likely to occur among young and middlejaged individuals (30-69 years). This is because Indians experience CVD deaths at least a decade earlier than their counterparts in developed countries. This has the potential to adversely affect India's economy with 52% of CVD deaths occurring in those below the age of 70 years compared to 23% in countries in established market economies. 4 Demographic and health transij j tions, genejenvironmental interactions and early life influences of fetal malnuj j trition have been implicated as the causes of increasing CVD burden in India. • to conduct a baseline survey and continual surveillance of CVD risk f...

C ardiovascular diseases (CVDs) are the leading cause of death in many regions of the world (1). Elevated blood pressure, blood sugar, serum cholesterol, body mass index, and tobacco use, all established risk factors for CVD, have a direct and linear relationship with CVD (2-7). All of these risk factors are linked to lifestyle changes (4).Although reasonable evidence exists for the beneficial role of risk factor reduction in decreasing CVD risk among individuals at high risk, primary or primordial prevention programs that use populationbased approaches have yielded equivocal results (8,9). For example, a meta-analysis of all population-based studies conducted largely in developed countries has suggested that health promotion (involving health education, mass media, and community organization) does not reduce mortality significantly but leads to small yet potentially beneficial reduction in risk factor levels (10). Several reasons have been attributed to this equivocal result of health promotion. These include shorter duration of intervention, improper design to evaluate the benefits, contamination (adoption of components of health intervention by the control community), and a declining trend of CVD in developed countries during the intervention period. However, by contrast, in developing countries the current prevailing secular trend seems to be a rapidly increasing burden of CVD and its risk factors. Therefore it is likely that a community-based approach may show the desired results of reducing CVD risk factors in developing country settings. For example, a primary prevention and health promotion initiative in Mauritius showed a pronounced decrease in the population level total cholesterol concentrations after 5 years of the intervention program (11).India is experiencing an accelerated epidemiological transition with a consequent increase in the burden of CVD risk factors both in community-based studies and in industrial populations (12)(13)(14)(15)(16). Given this background, we hypothesized that a comprehensive CVD risk factor reduction program comprising of a multipronged strategy of health promotion, high-

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There are wide regional variations in the prevalence of DM in India. The high burden of undetected diabetes, even in settings with universal access to on-site health care, highlights the need for innovative prevention and control strategies.

Introduction Cardiovascular dysautonomia comprising postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (OH) is one of the presentations in COVID-19 recovered subjects. We aim to determine the prevalence of cardiovascular dysautonomia in post COVID-19 patients and to evaluate an Artificial Intelligence (AI) model to identify time domain heart rate variability (HRV) measures most suitable for short term ECG in these subjects. Methods This observational study enrolled 92 recently COVID-19 recovered subjects who underwent measurement of heart rate and blood pressure response to standing up from supine position and a 12-lead ECG recording for 60 s period during supine paced breathing. Using feature extraction, ECG features including those of HRV (RMSSD and SDNN) were obtained. An AI model was constructed with ShAP AI interpretability to determine time domain HRV features representing post COVID-19 recovered state. In addition, 120 healthy volunteers were enrolled as controls. Results Cardiovascular dysautonomia was present in 15.21% (OH:13.04%; POTS:2.17%) . Patients with OH had significantly lower HRV and higher inflammatory markers. HRV (RMSSD) was significantly lower in post COVID-19 patients compared to healthy controls (13.9 ± 11.8 ms vs 19.9 ± 19.5 ms; P = 0.01) with inverse correlation between HRV and inflammatory markers. Multiple perceptron was best performing AI model with HRV(RMSSD) being the top time domain HRV feature distinguishing between COVID-19 recovered patients and healthy controls. Conclusion Present study showed that cardiovascular dysautonomia is common in COVID-19 recovered subjects with a significantly lower HRV compared to healthy controls. The AI model was able to distinguish between COVID-19 recovered patients and healthy controls.