Indication and frequency of implantation of permanent pacemaker in complete heart block patients in a tertiary care hospital in Rawalpindi

Objective: To find out the indication and frequency of permanent pacemaker implantation in complete heart block patients [CHB]

Study Design: Prospective cohort study

Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi for a period of six months from Mar 2016 to Sep 2016

Material and Methods: Total 153 patients of both genders coming to Rawalpindi Institute of Cardiology with complete heart block were included in the study. The patients fulfilling the inclusion criteria were evaluated for the etiology of complete heart block by history, physical examination, electrocardiography, blood tests, chest x-ray and echocardiography. Later their outcome [pacemaker implantation/medical treatment/death] was determined

Results: Myocardial infarction was found out to be the cause for CHB in 32.1 percent patients. Out of 153 patients, 12 patients died. In the remaining 141 patients, 77 were implanted with a pacemaker

Conclusions: Myocardial infarction accounted for 32.1 percent cases of complete heart block and a significant number of patients were implanted with a permanent pacemaker. Hence the trend of pacemaker use is on a rise

Effects of two functionally important SLCO1B1 gene polymorphisms on pharmacokinetics of atorvastatin

Organic anion transporter polypeptide 1B1 [OATP1B1] encoded by [SLCO1B1] gene, an uptake transporter involved in the transport of drugs and endogenous compounds and located in hepatocyte sinusoidal membrane. Objective of study was to investigate the effects of two functionally significant SNPs [388A>G and 521T>C] and their respective genotypes of SLCO1B1 gene encoding OATP1B1 on the pharmiacokinetics of atorvastatin. A total of 100 subjects divided into 6 groups as per their genotype profile were recruited. A single dose of 80mg atorvastatin was orally administered and plasma concentration measured up to 48 hours. The 388A>G and 521T>C genotypes were significantly associated with each other when compared for AUC and C[MAX] but exhibited no significant variations in T[MAX] and ti/[2]. 521 SNP is rather more strongly associated with altered pharmacokinetics of atorvastatin when compared with the 388 SNP, though the homozygous bi-allelic variant of 388 SNP also exhibited a fairly significant variation along with homozygous bi-allelic variant of 521 SNP. The inter-individual variation in pharmacokinetics can be explained by SLCO1B1 polymorphism