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All Journal Heart Science Journal
Wikananda, Adhika Prastya
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Impact of Strict and Lenient Heart Rate Control on Six-Minute Walk Test and Quality of Life in Atrial-Fibrillation Patients with Rheumatic Mitral Stenosis : Randomized Control Trial Dwigustiningrum, Nur Kaputrin; Rizal, Ardian; Putri, Valerinna Yogibuana Swastika; Rahimah, Anna Fuji; Rohman, Mohammad Saifur; Wikananda, Adhika Prastya; Waranugraha, Yoga; Astiawati, Tri; Laitupa, Fitranti Suciati
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.8

Abstract

Background: Recent studies showed no outcome difference between strict and lenient rate control in the general Atrial Fibrillation (AF) population. However, for AF and Rheumatic Mitral Stenosis (RMS) patients, evidences were lacking.Objective: To assess the impact of strict and lenient heart rate control on the Six-Minute Walk Test (SMWT) and Health Related Quality of Life (HRQoL) in patients with AF and RMS.Material and Methods: A prospective multicenter trial across tertiary hospitals in East Java assessed strict and lenient heart rate control's impact on the SMWT and HRQoL in AF and RMS patients. Sixty-one participants were randomized into strict and lenient groups over six months from March to August 2023. Medications were adjusted to achieve target heart rates, and HRQoL was assessed using SF-36 and SMWT at baseline and three months post-target heart rate attainment.Result: In our study, 29 patients were under strict heart rate control, and 32 were under lenient control. We found a decrease in HRQoL across all subscales, with significant differences observed in general health perception and physical function among those under strict control (p=0.002 and 0.03, respectively). However, no significant disparity was found in the SMWT distance difference between lenient and strict groups (p=0.529), nor in METs (p=0.326).Conclusion: In the study, lenient heart rate control demonstrates significant effects on the general health perception and physical function subscales compared to strict heart rate control. 
Case series analysis: Atrial fibrillation ablation with normal vs. left atrium enlargement Baskoro, Shalahuddin Suryo; Saerang, Gebryel Dennis; Saputri, Vemmy Lian; Rizal, Ardian; Wikananda, Adhika Prastya; Waranugraha, Yoga
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.2025.006.02.15

Abstract

Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and its incidence is gradually increasing worldwide. It can develop such life-threatening conditions as heart failure, myocardial infarction, and thromboembolism. Catheter ablation, as a minimally invasive procedure to eliminate AF triggers, demonstrates different levels of success, particularly in relation to the size of the left atrium (LA). Even though left atrium enlargement (LAE) associates with worse ablation outcomes, its mechanisms are poorly understood. Case Illustration: This case report investigated the treatment results in AF ablation cases with normal LA size and LAE. This case report described two paroxysmal AF patients who underwent catheter ablation. The patient of the first case is a 45-year-old male with normal LA Size, while the second case is a 55-year-old male with LAE. Both of these patients underwent pulmonary vein isolation (PVI) using a 3D mapping system. Sinus rhythm was gained in both patients before the discharge and both performed the ablation successfully. Conclusion: Left Atrial Enlargement (LAE) exposed patient to more difficult procedures and greater risk of recurrence. LA size is one of the predictor of long term outcome in AF ablation patients, but with proper management, the prognosis might still be favourable. More studies need to determine how to manage AF ablation in patients with high-risk characteristics 
Acute pulmonary embolism following radiofrequency catheter ablation in a young asian female on hormonal contraceptive injection Triatmojo, Nicodemus; Rizal, Ardian; Wikananda, Adhika Prastya; Kurnianingsih, Novi; Anjarwani, Setyasih
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.17

Abstract

Background: Acute pulmonary embolism (APE) is an uncommon yet severe complication following radiofrequency catheter ablation (RFCA) for arrhythmic disorders, with reported incidences ranging from 0% to 1.7%. Hormonal contraceptive injections, specifically Depot Medroxyprogesterone Acetate, significantly increase the risk of venous thrombosis. Early identification of APE is challenging due to non-specific symptoms, but critical indicators include sudden shortness of breath, chest pain, and loss of consciousness. Timely and tailored treatment, including weight-based dose adjustments for fibrinolytic therapy in Asian patients, is crucial for optimal outcomes. Case Presentation: We present the case of a 23-year-old Asian female with no prior history of thromboembolic diseases, who was on Depot Medroxyprogesterone Acetate for contraception. She underwent an uncomplicated RFCA procedure for frequent premature ventricular contractions. Patient was immobilized for nine hours post-procedure, upon her first attempt to mobilize and walk to the bathroom, she suddenly experienced shortness of breath, chest pain, and a brief loss of consciousness. Her vital signs were unstable, with a blood pressure of 85/55 mmHg, heart rate of 133 bpm, respiratory rate of 32 breaths/minute, and oxygen saturation of 88%. Echocardiography revealed right ventricular dilatation and a positive McConnell sign. A CT pulmonary angiography confirmed a filling defect in the left pulmonary artery, leading to an APE diagnosis. Considering her Asian ethnicity and low BMI, the patient was successfully treated with a reduced dose of alteplase (50 mg) administered over two hours to minimize bleeding risk. Her vital signs stabilized during fibrinolytic therapy, with no hemorrhagic complications. Following three months of oral rivaroxaban treatment, a follow-up CT pulmonary angiography revealed complete resolution of the embolism. Conclusions: This case underscores that APE, though rare, is a serious complication of RFCA, especially when combined with prolonged immobilization and hormonal contraceptive use. The abrupt onset of symptoms, including shortness of breath and loss of consciousness upon initial mobilization, is a critical indicator of Acute PE. Early mobilization within 2-4 hours post-RFCA is indicated to minimize embolic risk. Individualized treatment strategies, such as weight-based fibrinolytic dosing, are essential for managing APE in specific patient populations to optimize efficacy and safety. Clinicians should exercise caution with patients using hormonal contraception undergoing procedures involving vascular puncture.
Co-Authors Anjarwani, Setyasih Astiawati, Tri Baskoro, Shalahuddin Suryo Dwigustiningrum, Nur Kaputrin Kurnianingsih, Novi Laitupa, Fitranti Suciati Mohammad Saifur Rohman Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rizal, Ardian Saerang, Gebryel Dennis Saputri, Vemmy Lian Triatmojo, Nicodemus Yoga Waranugraha