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All Journal Jurnal Kedokteran Heart Science Journal
Irmansyah, Yos Akbar
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Journal : Heart Science Journal

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A rare case of reel syndrome: The unexpected permanent pacemaker event Irmansyah, Yos Akbar; Irnizarifka
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.16

Abstract

BACKGROUND: "Reel syndrome" is a rare complication that occurs after implantation, affecting up to 1.7% of patients with large generator pockets. This condition generally manifests 4–6 weeks post-implantation. CASE ILLUSTRATION: A 64-year-old woman presented unexpectedly with exertional dyspnea and mild fatigue over the past two days. She has a history of pacemaker installation from one month ago. The ECG demonstrated loss of capture, and pacemaker interrogation showed increased capture thresholds with normal impedance. A chest X-ray revealed a ventricular lead coil encircling the generator with lead dislodgment. Reel syndrome is defined by the torsion of the pulse generator along its transverse axis, leading to the coiling of the pacemaker leads around it, which typically protects both the generator and the leads from damage. Symptoms remain asymptomatic until lead dysfunction occurs due to lead malposition. We suggest appropriate diagnostic assessments, such as chest X-rays and ECGs, for prompt identification. The older population has been recognized as a considerable risk factor for this "event." CONCLUSION: Upon confirmation, reel syndromes require immediate intervention. Effective implantation techniques and information for patients and caregivers are essential in alleviating these issues.
The role of cardiac rehabilitation in heart failure: A review from an evidence-based approach Irmansyah, Yos Akbar; Widi, Vina Sari Nugrahaning; Martiana, Astri Kurniati
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.6

Abstract

Heart failure (HF) is a complex global health challenge caused by a structural and/or functional cardiac abnormality. Pharmacological medication remains a cornerstone of its management, but most patients continue to experience limited exercise capacity, which leads to decreased quality of life. Those limitations have led to the emergence of cardiac rehabilitation (CR) as a crucial part of HF management. It is a non-pharmacological, multidisciplinary approach to heart failure that aims to improve a patient’s functional capacity, reduce the risk of hospitalization, and improve long-term survival. Cardiac rehabilitation integrates structured exercise training, lifestyle modifications, and psychosocial support, customized to meet each individual’s needs. Studies demonstrate that exercise capacity, muscle strength, and respiratory efficiency are enhanced with aerobic exercise, resistance training, and inspiratory muscle training. Despite the proven efficacy, there is a significant underutilization of cardiac rehabilitation due to limited availability, low awareness, and patient adherence to the programs. This review article synthesizes evidence from PubMed, Scopus, and reference lists of relevant studies published up to July 2025 highlights the necessity of integrating CR into standard heart failure management and focusing on individualized rehabilitation programs. Enhancing the availability of CR programs could significantly alleviate the burden of HF, improve outcomes, and reduce healthcare expenses associated with frequent hospitalizations. Future research should prioritize a multidisciplinary team approach and patient education to align evidence-based recommendations with practical application.
Co-Authors Aini, Siti Rahmatul Erwin Kresnoadi, Erwin Irnizarifka Martiana, Astri Kurniati Widi, Vina Sari Nugrahaning