Article Per Year (5 Year)
p-Index From 2021 - 2026
4.056
P-Index
This Author published in this journals
All Journal Jurnal Kedokteran Brawijaya Indonesian Journal on Computing (Indo-JC) Heart Science Journal Jurnal Klinik dan Riset Kesehatan
Rizal, Ardian
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

Published : 31 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 31 Documents
Search

 1   2   3   4 
When coronary anomalies induce arrhytmias: A case of ventricular tachycardia due to left coronary artery-pulmonary artery fistula Saerang, Gebryel Dennis; Rizal, Ardian; Karolina, Wella
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.20

Abstract

Background: Coronary artery fistula (CAF) is a rare vascular anomaly involving an abnormal connection between a coronary artery and another cardiac or vascular structure. Although often asymptomatic, CAF can cause myocardial ischemia, presenting as angina, dyspnea, or ventricular arrhythmias, due to flow diversion, leading to a coronary stealing phenomenon that poses a serious clinical challenge. Case: An 81-year-old female presented with chest pain, palpitations, and syncope. Electrocardiography (ECG) showed monomorphic VT, successfully cardioverted and managed with amiodarone. Following initial stabilization, she experienced recurrent episodes of VT that were terminated with lidocaine. Physical examination revealed a continuous machinery murmur at the left upper sternal border. Transthoracic echocardiography showed left coronary artery dilation with turbulent flow into the pulmonary artery. Aortography and coronary angiography confirmed a dilated left main coronary artery with an aneurysmal segment and a tortuous fistulous tract to the pulmonary artery. Computed tomography coronary angiography (CTCA) with 3D reconstruction confirmed a left coronary artery fistula to the pulmonary artery. Conclusion: This case highlights CAF as an uncommon yet clinically important etiology of recurrent VT, likely attributable to the coronary stealing phenomenon. Multimodal imaging, especially CTCA, is crucial for diagnosis and treatment planning. In addition to immediate management with cardioversion/defibrillation and antiarrhythmic drugs, treatment of ischemia as the underlying cause is important in the management of ischemia-induced VT. CAF closure is recommended in symptomatic or hemodynamically significant CAF to alleviate ischemic symptoms and prevent complication.
Ablasi 3-Dimensi pada Pasien dengan Takikardia Right Ventricular Out-flow Track (RVOT) Origin: Pengalaman Pertama di RSUD Dr. Saiful Anwar Provinsi Jawa Timur Cik, Kahadi; Rizal, Ardian
Jurnal Klinik dan Riset Kesehatan Vol 3 No 3 (2024): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.3.9

Abstract

Background: Premature ventricular complexes (PVCs) occur commonly in general population. It can occur in patient without structural heart disease as well as those with any form of cardiac disease. Commonly PVCs are asymptomatic, but in patients with frequent PVCs causing palpitations, syncope or dizziness, easily to fatigue, or shortness of breath. PVCs has been connected with a more than two-fold higher risk of cardiovascular events including stroke, mortality and also associated with arrhythmias or cardiomyopathy. Medications can be used to suppress PVCs but when drug therapy is ineffective, PVC ablation is reasonable to eliminate symptoms and treat or prevent PVC-induced cardiomyopathy. Case Presentation: A hypertension and menopause, 57-year-old woman, frequently complained about palpitation with shortness of breath, dizziness and sometimes near syncope since 2017, occurring both at rest and with mild activities. After serial examinations, found Frequent PVC (39%) with RVOT-Origin and reduced ejection fraction (EF 48%), then conclude with Suspect Tachycardia Induced cardiomyopathies. She performs cardiac electrophysiological study and continue with 3-Dimentional Ablation with Radiofrequency (RFA) at RVOT in Saiful Anwar Hospital, that is The First 3-Dimension Ablation in East Java. 1 year follow up shows no recurrency and successful to improve quality of life of the patient Discussion: According to guideline, catheter ablation is class I recommendation for patients with symptomatic outflow tract ventricular arrhythmias if medications are ineffective, not tolerated, or patient’s choose Conclusion: Three-Dimensional Ablation at patient with Right Ventricular Outflow Track Tachycardia, can successfully eliminate PVCs with no recurrency in 1 year follow-up.
Ventricular Tachycardia Storm Management in Acute Cardiac Care: Prompt response to life-threatening conditions Lestari, Puspa; Anjarwani, Setyasih; Rohman, Mohammad Saifur; Rizal, Ardian
Heart Science Journal Vol. 4 No. 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.7

Abstract

Background: Ventricular Tachycardia (VT) storm or electrical storm (ES) is defined as cardiac electrical instability and refers to the occurrence of three or more ventricular tachyarrhythmias (VT and or ventricular fibrillation (VF)) in a 24-hour period, or VT recurring soon (within five minutes) after termination of another VT episode, or sustained or no sustained VT with total ectopic beats greater than sinus beats in a 24-hour period. The frequency of VT storms varies on population. When ICDs are implanted for primary prevention (4 percent), it is lower than when they are implanted for secondary prevention (20 percent).Case Summary: We presented patient with Ventricular Tachycardia (VT) storm. A 63-year old woman was admitted to emergency room with chief complaint frequent episodes of palpitation. She was found to have monomorphic VT with unstable hemodynamic. Then she got cardioversion 100 Joule, continued with lidocaine drip and VT reverted to sinus rhythm. Patient admitted to cardiovascular care unit, but she had VT refractory. She got complete revascularization for coronary artery before, but the episodic of VT still occurred with cardiogenic shock (CS) and pulmonary edema. She got cardioversion, amiodarone iv and inotropes, then observed this patient at CVCU. After the condition stable, this patient was discharged and planned for ICD insertion at the next admission.Discussion: We discuss the various available treatment options for VT storm and practical challenges faced in management of hemodynamically unstable VT storm. Initial management involves identifying and correcting the underlying ischemia, electrolyte imbalances, or other inciting factors.
Acute Hemodynamic Index as a Predictor of In-Hospital Mortality in Mechanical Ventilated Acute Decompensated Heart Failure Patients Kurniawan, Dea Arie; Anjarwani, Setyasih; Rizal, Ardian; Satrijo, Budi; Yogibuana, Valerinna
Heart Science Journal Vol. 4 No. 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.4

Abstract

Background: The likelihood of a poor clinical outcome is significantly increased in patients with acute decompensated heart failure. Mechanical ventilation was necessary for 23% of ADHF patients receiving treatment. The simple parameters of blood pressure and heart rate have good accuracy and repeatability. The development of the Acute Hemodynamic Index allowed for the calculation of pulse pressure and heart rate to be used as a basis for predicting intrahospital mortality.Methods: The medical records of patients who received care at CVCU RSSA were used in this retrospective, single-center study. ROC analysis and multivariate regression analysis were used to evaluate the prognostic performance of AHI. Statistical significance was determined by the P value of 0.05 or lower.Results: 252 patients with heart failure and low ejection fraction had their data analyzed. Hospital mortality is 82 percent. The cut-off was 4.19 mmHg/bpm, which was the AHI value. 68.8% of patients with fatal illnesses had low AHIs ( 4.19 mmHgbpm). AHI > 4.19 mmHgbpm patients have a 9-fold increased risk of dying in the hospital than patients with low AHI. AUC: 0.825 [0.743-0.907]; sensitivity: 0.814; specificity: 0.689; AUC: 0.825 [0.743-0.907; p = 0.000]; demonstrate the high predictive power of AHI.Conclusion: AHI has a strong degree of association with the likelihood of dying in the hospital from acute decompensated heart failure.
Atrial Fibrillation Development Risk Associated with Metabolic Syndrome Alfata, Fandy Hazzy; Rizal, Ardian; Rohman, Mohammad Saifur; Rahimah, Anna Fuji
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.2

Abstract

Even in the absence of antecedent myocardial infarction or congestive heart failure, atrial fibrillation (AF) is the most frequent arrhythmia seen in daily practice. There are several important predisposing factors for the initiationof AF, including growing older, being a man, being female, having high blood pressure, and having cardiac and noncardiac illnesses. Metabolic syndrome (MS) contributes to the progression of AF through its impact on the atrial substrate. MS involves metabolic risk factors that increase the likelihood of atherosclerotic cardiovascular disease and type 2 diabetes. Insulin resistance plays a significant role in MS pathophysiology, leading to glucose and lipid metabolism dysregulation, increased inflammation, and neurohormonal activation. These processes contribute to the development of hypertension, a major risk factor for AF. Atrial remodeling, including electrical and structural changes, is a common substrate for AF, and MS components further contribute to this remodeling.Hypertension, a key feature of MS, is associated with structural, contractile, and electrical remodeling in the atria, increasing the risk of AF. The renin-angiotensin-aldosterone system, implicated in hypertension regulation, alsoinfluences the pathophysiology of AF through fibrosis, ion channel alterations, oxidative stress, and inflammation. Understanding the intricate interplay between MS and AF can provide insights into therapeutic strategies for managing these conditions and reducing cardiovascular risks.
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

Abstract

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.
Fever-Induced Brugada-Pattern Electrocardiogram Nugraha, Yudha Tria; Prasetya, Indra; Martini, Heny; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.7

Abstract

Background: The Brugada syndrome is a type of cardiac arrhythmia frequently overlooked because of the dynamic character of the condition. Because it tends to progress into ventricular arrhythmias, it is a disorder that, if left untreated, carries the risk of being deadly. Not only is it essential for the practicing clinician to understand the situations that can disclose the concealed Brugada syndrome, but it is also essential for patients to understand these circumstances so that they can be educated to seek medical assistance quickly. This study aimed to describe the diagnosis and management of fever-induced Brugada pattern electrocardiogramCase presentation: Male in his 42-year-old with a history of intermittent fever for four days before hospital admission. High-degree fever was only relieved by taking antipyretics and was accompanied by nausea and muscle and joint pain. Upon arrival at the emergency department, he denied any complaints of chest pain or discomfort, shortness of breath, orthopnea, PND, leg swelling, palpitation, or syncope. A chest radiograph showed normal cardiac and pulmo (Figure 1); a first electrocardiogram showed Sinus Rhythm, HR 112 bpm, regular, FA normal, HA normal, P wave normal, PR interval 160 msec, QRS 80 msec, QTc 326 msec, Coved ST elevation at lead V1 (1 mm), V2 (3 mm), T inversion at lead V1-V2, suggesting sinus tachycardia with type II Brugada pattern.Conclusion: A Brugada pattern can be exposed to several stimuli, but fever is particularly potent. To assist urgent or emergency follow-up in cardiology, Emergency physicians must be informed of specific ECG findings based on the patient's clinical risk factors. The emergency doctor must be able to tell the difference between this pattern and a typical variation of RBBB, as a delayed diagnosis can have dire consequences.
Correlation Study of Cotinine and Monocyte Chemoattractant Protein-1 (MCP-1) with Carotid Intima-Media Thickness (cIMT) in Male Active Tobacco Smoke Satwikajati, Sawitri; Kurnianingsih, Novi; Tjahjono, Cholid Tri; Wihastuti, Titin Andri; Sargowo, Djanggan; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.6

Abstract

Background : Tobacco smoke exposure induces intima-media thickness by reducing nitric oxide and increasing adhesive molecule activity, with circulating cotinine serving as a marker; we hypothesize a correlation between monocyte chemoattractant protein-1 (MCP-1) and carotid intima-media thickness (cIMT) in active male smokers. Method : We conducted an observational cross-sectional analytic study involving 125 male participants, with 62 being active tobacco smokers and 63 non-smokers. Data were presented as mean ± SD, and the correlation between variables was analyzed using Pearson correlation. Result : Cotinine and MCP-1 levels were significantly higher in the smoker population (p 0.000) compared to non-smokers. The incidence of positive cIMT findings was higher in the smoker group (5%) than in the non-smoker group (2%). In the active smoker population, cotinine (r 0.21; p 0.11) showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 showed a negative correlation (r -0.19, p 0.14) with positive cIMT findings. Smoking duration (r 0.162; p 0.223) and the amount of tobacco smoke (r 0.003; p 0.982) demonstrated a positive correlation with cotinine. MCP-1 exhibited a non-significant positive correlation with smoking duration (r 0.122; p 0.345) and a non-significant negative correlation with the amount of tobacco smoke (r -0.002; p 0.989). Conclusion : Among active tobacco smokers, cotinine showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 exhibited a non-significant negative correlation with positive cIMT findings. 
Challenge case of ventricular arrhythmia in young women Kaputrin, Nur; Rizal, Ardian; Karolina, Wella; Widito, Sasmojo
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.2025.006.01.16

Abstract

Background: Torsade de pointes (TdP) and ventricular fibrillation can cause rapid mortality. The etiological cause the ventricular arrhythmia must be detected and treated early, especially in the ER. Objective: We report a patient with severe hypokalemia and TdP following the administration of Amiodarone in QT-interval prolongation Case Report: A 32-year-old girl with diarrhea and vomiting for two days arrived to the ED with a seizure with her hand flexed and leg straight down. Her family reported she didn't take prescriptions regularly. She was GCS 224, hemodynamically stable, typical ECG showed extended QTc and her head CT was normal. During observation at the ED, she had seizure and the monitor revealed a Torsade de Pointes (TdP) ) with a pulse rate of 160-180 bpm. She was given Amiodarone and peroral Bisoprolol 5 mg. She returned to sinus rhythm with PVC bigeminy and was admitted to the ICU Laboratory data showed hypokalemia (1.9) improved (2.9) after treatment. Eight hours later, she experienced a TdP without pulse palpability for less than 1 minute, then Ventricular Fibrillation, began CPR, and the doctor in charge gave her a defibrillation operation once. She returned with sinus tachycardia 110-130 bpm. The next day, she was having recurring TdP episodes without a pulse. The doctor conducted CPR and defibrillation and returned with 120-130 bpm sinus tachycardia. The patient consulted a cardiologist and was prescribed lidocaine 1 mg/hour and continued Bisoprolol 5 mg for long QT problem. Observation The seizure ended 12 hours later, the patient was alert, GCS 456, and the ECG showed sinus rhythm with extended QTc. Over the days before discharge, electrocardiography demonstrated reduced QT-interval prolongation. Conclusion: Life-threatening ventricular arrhythmia in a young female can be caused by QT-interval prolongation. It must be diagnosed and treated immediately to avoid mortality.
Study of Machine Learning Algorithm on Phonocardiogram Signals for Detecting of Coronary Artery Disease Mandala, Satria; Pramudyo, Miftah; Rizal, Ardian; Fikry, Maurice
Indonesian Journal on Computing (Indo-JC) Vol. 5 No. 3 (2020): December, 2020
Publisher : School of Computing, Telkom University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34818/INDOJC.2020.5.3.536

Abstract

Several methods of detecting coronary artery disease (CAD) have been developed, but they are expensive and generally use an invasive catheterization method. This research provides a solution to this problem by developing an inexpensive and non-invasive digital stethoscope for detecting CAD. To prove the effectiveness of this device, twenty-one subjects consisting of 11 CAD patients and 10 healthy people from Hasan Sadikin Hospital Bandung were selected as validation test participants. In addition, auscultation was carried out at four different locations around their chests, such as the aorta, pulmonary, tricuspid, and mitral. Then the phonocardiogram data taken from the stethoscope were analyzed using machine learning. To obtain optimal detection accuracy, several types of kernels such as radial basis function kernel (RBF), polynomial kernel and linear kernel of Support Vector Machine (SVM) have been analyzed. The experimental results show that the linear kernel outperforms compared to others; it provides a detection accuracy around 66%. Followed by RBF is 56% and Polynomial is 46%. In addition, the observation of phonocardiogram signals around the aorta is highly correlated with CAD, giving an average detection accuracy for the kernel of 66%; followed by 44% tricuspid and 43% pulmonary.
Co-Authors Adi Nugroho, Dwi Adi, Andi Wahjono Alfata, Fandy Hazzy Anjarwani, Setyasih Arif Wicaksono Astiawati, Tri Aziz, Indra Jabbar Baskoro, Shalahuddin Suryo Cholid Tri Tjahjono Cik, Kahadi Djanggan Sargowo Dwigustiningrum, Nur Kaputrin Fikry, Maurice Galuh, Lukitasari Ayu Haryati, Lina Indra Prasetya Inggita Kusumastuty Kahadi, Cik Kaputrin, Nur Karolina, Wella Kurnianingsih, Novi Kurniawan, Dea Arie Laitupa, Fitranti Suciati Lestari, Puspa Martini, Heny Mohammad Saifur Rohman Noverike, Nikhen Nugraha, Krishna Ari Nugraha, Yudha Tria Pramudyo, Miftah Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rochmawati, Icmi Dian Saerang, Gebryel Dennis Saputri, Vemmy Lian Satria Mandala Satrijo, Budi Satwikajati, Sawitri Setiawan, Dion Suprapto, Ratih Paramita Suprayoga, Imam Mi'raj Titin Andri Wihastuti Widito, Sasmojo Wikananda, Adhika Prastya Yoga Waranugraha Yogibuana, Valerinna