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Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.

Transcatheter atrial septal defect closure: Focus on tips and tricks for interventional procedure in challenging cases Setiawan, Dion; Putri, Valerinna Yogibuana Swastika; Martini, Heny; Karolina, Wella
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.6

The ostium secundum defect is the most prevalent form of atrial septal defect (ASD). The development and refinement of devices and techniques for transcatheter ASD closure have led to its acceptance as the preferred management for most patients with secundum ASD. Meticulous planning and execution constitute the key to achieving success in a procedure. It entails a thorough assessment of the patient, beginning with selecting suitable cases, as well as detailed pre- and intraprocedural imaging, knowledge of various device deployment techniques, anticipation of potential complications, and appropriate management strategies. This review article will discuss tips and tricks to overcome the technical intricacies of achieving a successful transcatheter ASD closure and address some challenging cases associated with its use.

Time components contributing to door-to-balloon time of patients with ST-elevation myocardial infarction Setiawan, Dion; Anjarwani, Setyasih; Rohman, Mohammad Saifur
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.3

Timely percutaneous coronary intervention (PCI) for patients experiencing ST-segment elevation myocardial infarction (STEMI) can greatly decrease mortality and morbidity. However, delays can hinder its effectiveness. The interval from hospital admission to reperfusion with PCI, known as door-to-balloon time (D2B), is closely linked to patient outcomes and is a key indicator of hospital quality. European guidelines suggest a D2B time of 90 minutes or less. Furthermore, some registries break down the D2B time into component times. These components include the time needed to identify a STEMI and activate the catheterization lab (door-to-activation time), the time for lab preparation and patient transport (activation-to-laboratory time), and the time from lab arrival to the initial use of devices to open the blocked artery (laboratory-to-balloon time). In Indonesia, factors such as population diversity, cultural beliefs, health literacy, and national insurance processes may affect D2B times. Understanding these components can help develop strategies to reduce delays. Understanding each component of D2B time and its contributing factors can aid physicians in developing effective strategies to reduce D2B delays.

Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.

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