Vanita Arora

Bio: Vanita Arora is an academic researcher from Max Healthcare. The author has contributed to research in topics: Electrical conduction system of the heart & Cardiac resynchronization therapy. The author has an hindex of 2, co-authored 9 publications receiving 95 citations.

Left bundle branch pacing: A comprehensive review.

Abstract: Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow-up. Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease. This paper will focus on the implantation technique, troubleshooting, clinical implications, and a review of published literature of LBBP.

Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society.

Abstract: Not needed.

Physiological Pacing: A New Road to Future

Abstract: Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than ...

Reply to letters regarding our paper "Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Societyˮ.

Abstract: The authors thank Gupta et al. [1] and Mahendran et al. [2] for their interest and comments on our paper titled ‘Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society’ [3] Authors of both letters have raised similar points regarding method to compute QTc interval. We agree that there are numerous formulae that attempt to correct QT for heart rate using exponential methods [4,5,12], linear correlation [6e9], logarithmic correction [10], and others [11]. There is considerable disagreement on which method is best for this purpose. As such, QTc is a derived value computed by one of these formulae. Therefore, in absence of a direct measurement of QTc, or a gold standard for reference, it is nearly impossible to prove superiority of any method for accuracy. There are no large studies confirming superiority of one method over others in a consistent manner. Most clinical studies have used the Bazett’s formula for QTc correction and most outcome data that have associated risk of arrhythmic events based on QTc values in a LQT population are based on this formula. Bazett’s formula was the first and remains most widely recognized and used method. It is mentioned in all current Cardiology and ECG textbooks, and also specifically recommended to calculate Schwartz score for diagnosis of long QT syndrome [13]. It is also the default formula for most QT interval correction apps. Since the guidelines are meant for a wider audience including general physicians, the emphasis was on simplicity. Also, the paper is not primarily about QT interval, but on how to risk stratify and monitor COVID-19 suspects or patients who are to receive hydroxychloroquine for their treatment or prophylaxis. A detailed exposition of merits and demerits of different methods to compute QTc interval would have been a digression from the primary focus of the guidelines.

Discovery of SARS-CoV-2 antiviral drugs through large-scale compound repurposing.

Abstract: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 has triggered an ongoing global pandemic of the severe pneumonia-like disease coronavirus disease 2019 (COVID-19)1. The development of a vaccine is likely to take at least 12–18 months, and the typical timeline for approval of a new antiviral therapeutic agent can exceed 10 years. Thus, repurposing of known drugs could substantially accelerate the deployment of new therapies for COVID-19. Here we profiled a library of drugs encompassing approximately 12,000 clinical-stage or Food and Drug Administration (FDA)-approved small molecules to identify candidate therapeutic drugs for COVID-19. We report the identification of 100 molecules that inhibit viral replication of SARS-CoV-2, including 21 drugs that exhibit dose–response relationships. Of these, thirteen were found to harbour effective concentrations commensurate with probable achievable therapeutic doses in patients, including the PIKfyve kinase inhibitor apilimod2–4 and the cysteine protease inhibitors MDL-28170, Z LVG CHN2, VBY-825 and ONO 5334. Notably, MDL-28170, ONO 5334 and apilimod were found to antagonize viral replication in human pneumocyte-like cells derived from induced pluripotent stem cells, and apilimod also demonstrated antiviral efficacy in a primary human lung explant model. Since most of the molecules identified in this study have already advanced into the clinic, their known pharmacological and human safety profiles will enable accelerated preclinical and clinical evaluation of these drugs for the treatment of COVID-19. A screen of the ReFRAME library of approximately 12,000 known drugs for antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identified several candidate compounds with suitable activities and pharmacological profiles, which could potentially expedite the deployment of therapies for coronavirus disease 2019 (COVID-19).

Wearable Sensing and Telehealth Technology with Potential Applications in the Coronavirus Pandemic

Abstract: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic with serious clinical manifestations including death. A pandemic at the large-scale like COVID-19 places extraordinary demands on the world's health systems, dramatically devastates vulnerable populations, and critically threatens the global communities in an unprecedented way. While tremendous efforts at the frontline are placed on detecting the virus, providing treatments and developing vaccines, it is also critically important to examine the technologies and systems for tackling disease emergence, arresting its spread and especially the strategy for diseases prevention. The objective of this article is to review enabling technologies and systems with various application scenarios for handling the COVID-19 crisis. The article will focus specifically on 1) wearable devices suitable for monitoring the populations at risk and those in quarantine, both for evaluating the health status of caregivers and management personnel, and for facilitating triage processes for admission to hospitals; 2) unobtrusive sensing systems for detecting the disease and for monitoring patients with relatively mild symptoms whose clinical situation could suddenly worsen in improvised hospitals; and 3) telehealth technologies for the remote monitoring and diagnosis of COVID-19 and related diseases. Finally, further challenges and opportunities for future directions of development are highlighted.

How India is dealing with COVID-19 pandemic

Abstract: India, which has the second-largest population in the world is suffering severely from COVID-19 disease. By May 18th, India investigated ∼1 lakh (0.1million) infected cases from COVID-19, and as of 11th July the cases equalled 8 lakhs. Social distancing and lockdown rules were employed in India, which however had an additional impact on the economy, human living, and environment. Where a negative impact was observed for the economy and human life, the environment got a positive one. How India dealt and can potentially deal with these three factors during and post COVID-19 situation has been discussed here.

A Large-scale Drug Repositioning Survey for SARS-CoV-2 Antivirals

Abstract: The emergence of novel SARS coronavirus 2 (SARS-CoV-2) in 2019 has triggered an ongoing global pandemic of severe pneumonia-like disease designated as coronavirus disease 2019 (COVID-19). To date, more than 2.1 million confirmed cases and 139,500 deaths have been reported worldwide, and there are currently no medical countermeasures available to prevent or treat the disease. As the development of a vaccine could require at least 12-18 months, and the typical timeline from hit finding to drug registration of an antiviral is >10 years, repositioning of known drugs can significantly accelerate the development and deployment of therapies for COVID-19. To identify therapeutics that can be repurposed as SARS-CoV-2 antivirals, we profiled a library of known drugs encompassing approximately 12,000 clinical-stage or FDA-approved small molecules. Here, we report the identification of 30 known drugs that inhibit viral replication. Of these, six were characterized for cellular dose-activity relationships, and showed effective concentrations likely to be commensurate with therapeutic doses in patients. These include the PIKfyve kinase inhibitor Apilimod, cysteine protease inhibitors MDL-28170, Z LVG CHN2, VBY-825, and ONO 5334, and the CCR1 antagonist MLN-3897. Since many of these molecules have advanced into the clinic, the known pharmacological and human safety profiles of these compounds will accelerate their preclinical and clinical evaluation for COVID-19 treatment.