Cardiac electrophysiology is the science of understanding heart rhythm. Various disorders affecting heart rhythm are known as arrhythmias. These can be life-threatening conditions, often requiring immediate medical attention. Kerala Heart Rhythm Society(KHRS) is a conglomerate of cardiologists interested in arrhythmias and cardiac electrophysiology in India’s southern state of Kerala. Kerala, also known as God’s own country, is in the southern part of the Indian subcontinent. 

Initial attempts at doing cardiac electrophysiology studies in Kerala started in the 1980s at Sree Chitra Tirunal Institute of Medical Sciences and Technology at Thiruvananthapuram, concomitant with the expansion of cardiology facilities in the state. During those days, electrophysiological studies, catheter ablation of accessory pathways (WPW syndrome), and other arrhythmias were performed using direct current.

Keeping in line with the adoption of newer and safer energy modalities like radiofrequency (RF) energy for catheter ablation in the Western world, the first RF ablation was done in SCTIMST in March 1992, and findings were presented in the annual meeting of the Cardiological Society at Hotel Taj Palace, New Delhi held in the first week of November 1992. This is considered one of the earliest attempts at radiofrequency ablation for cardiac arrhythmias in India.

Figure 1: First published report of radiofrequency ablation in the region in the CSI abstracts supplement of Indian Heart Journal November 1992.

Over the next two decades, there has been a steady increase in electrophysiologists and tertiary centres with state-of-the-art facilities, including 3D ablation of complex arrhythmias across the state. The contributions of Dr Jaganmohan A Tharakan, Dr Ajitkumar VK, and Dr Prakash Kamath are notable. Currently, treatment facilities for arrhythmias are available in most districts of Kerala.

Newer academic programs also paralleled this development, and the first dedicated fellowship course in cardiac electrophysiology was started for the first time in the country in SCTIMST in 2002. Dr Johnson Francis, the then Professor of Cardiology at Calicut Medical College, single-handedly initiated a journal in 2005 that later became Indian Pacing and Electrophysiology and the official journal of the Indian Heart Rhythm Society. Following Dr. Francis, Dr. Narayanan Namboodiri served as the editor-in-chief of this journal between 2014 and 2020.

Meanwhile, a group of like-minded cardiologists shared an interest in growing an EP community and enhancing the state’s awareness of arrhythmia. They convened in Thrissur alongside the meeting of the Cardiological Society of India Kerala chapter annual conference on 8 May 2010, generating an idea for an independent organization for cardiologists interested in arrhythmia and electrophysiology in the state. After this, a society was registered subsequently, and a bylaw was formulated with the first office bearers being Prof. Jaganmohan A Tharakan as president, Prof Ajitkumar VK as vice president, Dr Johnson Francis as secretary, Dr KK Narayanan Namboodiri as joint secretary and Dr PK Ashokan as treasurer. Five executive members were selected zonally, including Dr Sunitha Viswanathan, Dr KU Natarajan, Dr Rajeev E, Dr Haridas PV, and Dr Raveendran P. Following this, the first annual conference of the Society was held in Leela Palace Hotel, Kovalam, on 26 February 2011, with Dr. KK Narayanan Namboodiri as the organizing secretary and Dr. Ajitkumar VK as the organizing chairperson. 

Former presidents of the Society include Prof. Jaganmohan A Tharakan, Prof Ajitkumar VK, Prof. Johnson Francis, Prof. KU Natarajan and Prof. KK Narayanan Namboodiri, and Dr Ajith Thachil (2023 onwards).

The present office bearers include Dr Ajit Thachil as President, Dr Bhima Shankar as Vice President, Dr Praveen G Pai as Secretary,  and Dr Anees T as joint secretary. Dr Arun Gopi is the Treasurer and Dr Narayanan Namboodiri was Immediate Past President. Executive committee members include Dr PK Asokan, Dr Haridasan V, Dr Jyothivijay MS and Dr Rajeev E. 

Since 2011, KHRS annual conferences have been held every year in various parts of the state, with enthusiasm enhancing year by year. In addition, focused meetings and boot camps are being held to boost learning of electrophysiology. This includes the KHRS EP training program conducted on 24 January 2015 at Thiruvananthapuram and a webinar on atrial flutter on 18 February 2024. More than 110 cardiologists across the world attended. The Society also supports arrhythmia research through research grants and other charitable acts. 

As of March 2024, the Society has more than 50 cardiologists interested in electrophysiology, delivering high-quality arrhythmia care across the state. The state has become the frontrunner in the country in academic EP over the last decade, with many qualified electrophysiologists in the state with years of experience and overseas training to their credit. More than 500 articles in PubMed have been contributed by members of KHRS spearheading EP research in the Indian subcontinent.