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Successful Radiofrequency Catheter Ablation of The Para-Hisian Accessory Pathway in A Patient with Wolf Parkinson White Syndrome Ismir Fahri; Yoga Yuniadi; Dicky A Hanafy; Hauda El Rasyid
Jurnal Kardiologi Indonesia Vol. 32, No. 2 April - Juni 2011
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v32i2.107

Abstract

Radiofrequency catheter ablation of the accessory pathway in Wolff-Parkinson-White (WPW) syndrome is a highly successful mode of therapy. Sudden cardiac arrest survivors associated with WPW syndrome should undergo radiofrequency catheter ablation. Para-Hisian is one of unusual location accessory pathway in WPW syndrome associated with high risk complication of complete AV block during catheter ablation. Here we describe a case of patient who presented with history of palpitation due to WPW syndrome, electrophysiology study identified a para-Hisian accessory pathway so close to His bundle that discrete site between the pathway, the first ablation was unsuccessful and terminated due to the risk of complete AV block. The accessory pathway was successfully ablated in a second session using radiofrequency, although this entailed a great increase in the risk of causing complete atrioventricular block.
Aritmia Ventrikel Pasca Intervensi Koroner Perkutan : Petanda Reperfusi atau Iskemia yang Masih Berlangsung ? Meidianaser Putra; Hauda El Rasyid
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.797

Abstract

Aritmia ventrikel setelah IKP awalnya diindikasikan sebagai reperfusi yang sukses. Namun, beberapa penelitian menyebutkan bahwa aritmia ini diakibatkan oleh iskemia yang sedang berlangsung. Aritmia yang sering terjadi adalah kontraksi ventrikel premature sustained atau nonsustained takikardi ventrikel, accelerated idioventricular tachycardia, fibrilasi atrium, dan fibrilasi ventrikel. Gangguan irama dihubungkan dengan oklusi koroner didefinisikan sebagai aritmia iskemik, sedangkan aritmia terjadi akibat peningkatan perfusi miokard yang disebut aritmia reperfusi. Accelerated idioventricular tachycardiabisa menjadi penanda dari reperfusi awal dan patensi arteri berkelanjutan. Penatalaksanaan aritmia ventrikel pasca intervensi koroner perkutan meliputi penggunaan obat anti aritmia, overdrive pacing, ablasi radiofrekuensi, dan ICD. Kata kunci: aritmia ventrikel, IKP, obat anti aritmia, overdrive pacing, ablasi radiofrekuensi, dan ICD
Padang Skoring Elektrokardiografi untuk Memprediksi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Kronik Wiza Erlanda; Hauda El Rasyid; Masrul Syafri; Ricvan Dana Nindrea
Jurnal Kardiologi Indonesia Vol 39 No 4 (2018): Indonesian Journal of Cardiology: October-December 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i4.858

Abstract

ABSTRAK Latar Belakang: Gagal Jantung dibagi menjadi 3 kelompok yaitu gagal jantung fraksi ejeksi menurun (HfrEF <40%), rentang tengah (HFmrEF 40-49%), dan terpelihara (HfpEF ≥50%). Ekokardiografi masih menjadi pemeriksaan standar saat ini, sayangnya pemeriksaan tersebut masih terbatas dibeberapa pusat kesehatan. Perlu pemeriksaan awal yang lebih sederhana salah satunya elektrokardiografi (EKG) yang mudah digunakan. Penentuan skoring dari EKG diharapkan dapat memudahkan memprediksi fraksi ejeksi dan memberikan terapi yang tepat. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Diambil data rekam medis pasien gagal jantung kronik (GJK) di poliklinik Jantung RSUP Dr. M.Djamil Padang bulan Januari-Agustus 2017. Dilakukan analisis bivariat pada varibel EKG terhadap fraksi ejeksi dengan metode chi-square. Analisis multivariate dengan uji regresi binari logistik untuk mendapatkan variabel pada kalkulasi skor dengan uji Hosmer-Lameshow (p<0,25). Skoring dilakukan uji sensitivitas, spesifisitas dan analisis receiver operating curve (ROC). Hasil Penelitian : 283 subjek GJK dibagi menjadi tiga kelompok. Variabel yang memenuhi persyaratan untuk dilakukan kalkulasi skor adalah pembesaran atrium kiri (LAE) (OR=6,36; p= 0.000) dengan skor 2, QRS lebar (OR=13,06; p= 0.000) dengan skor 3, interval QTc memanjang (OR=2,18; p= 0.065) dengan skor 1 dan perubahan gelombang ST-T (OR=5,05; p= 0.000) dengan skor 2. Subjek dengan HFpEF mempunyai skor <3, HFmrEF mempunyai skor 3-4, dan HFrEF mempunyai skor >4. Sistem skoring EKG memiliki sensitivitas 71,4% dan spesifisitas 88,6% dengan AUC 87,9% Kesimpulan : Sistem skoring EKG pada penelitian ini dapat digunakan sebagai pedoman awal dalam menentukan fraksi ejeksi ventrikel kiri pada pasien GJK Kata kunci : elektrokardiografi, gagal jantung kronik, fraksi ejeksi ventrikel kiri Background: Heart failure (HF) are divided into HF reduced ejection fraction (HFrEF<40%), mid range (HFmrEF 40-49%), and preserved (HFpEF ≥50%). Nowadays echocardiography is used as gold standard examination, but it is limited only in several health centers. For this reason, a preliminary examination tools is needed. Electrocardiographic (ECG) examinations tool that available almost at every health center and easy to be used. Calculating the scores from ECG variables to determine the EF will make clinician’s earlier to give initial terapi Method: An observational approach with cross sectional study design. The data was taken from patient’s medical record with chronic heart failure (CHF) who went to the Tepartement of Cardiology at Dr. M. Djamil Padang Hospital in January-August 2017. Bivariate analysis was performed on each ECG variable then correlated with LVEF by chi-square method. Multivariate analysis with logistic binary regression test was conducted to obtain variables that would go into the score calculation stage with the Hosmer-Lameshow test (p <0.25). The sensitivity, specificity test and receiver operating curve (ROC) analysis were performed. Result: 283 subjects of CHF who had been divided into three groups. Obtained variables that met the requirements for calculating scores were left atrial enlargement (LAE) (OR = 6.36; p = 0.000) score was 2, wide QRS (OR = 13.06; p = 0,000) score was 3 , prolonged QTc interval (OR = 2,18; p = 0,065) score was 1 and ST-T change (OR = 5.05; p = 0.000) score was 2. Subjects with HFpEF if the scored were <3, HFmrEF if the scored were 3-4, and HFrEF if the scored were >4. It has sensitivity 71,4%, specificity 88,6% with AUC 87,9%. Conclusion: Electrocardiography scoring system in this study can be used as an initial tools to determining LVEF in patients with CHF. Keywords: electrocardiography, chronic heart failure, left ventricular ejection fraction
Diagnostic Value Of Qtc Dispersion And And Qt Dispersion Ratio Changes On Stress Test In Detecting Significance Of Coroner Lesion In Stable Angina Pectoris Patients putri yeantesa; Hauda El Rasyid; Masrul Syafri; Ricvan Dana Nindrea
Jurnal Kardiologi Indonesia Vol 40 No 2 (2019): Indonesian Journal of Cardiology: April-June 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i2.921

Abstract

Background : Treadmill exercise test remains an important method and often used in the initial evaluation of patients with chest pain and can be a filter for more expensive invasive diagnostic. Increased QT dispersion (QTD) occurs because of the heterogeneity of ventricular repolarization because transient ischaemia during a treadmill stress test can be a marker of coronary artery disease (CAD) and can improve the accuracy of exercise tests to diagnose CAD, but this parameter is still controversial. Method : This is an analytic observational approach with a cross sectional study. Data was taken retrospectively at the Heart Center Installation at RSUP Dr. M. Djamil Padang, from March to April 2019, stable angina pectoris patient with a positive treadmill stress test who underwent coronary angiography as the subject. Bivariate analysis was performed on changes in QTcD (∆QTcD) and QTdR (∆QTdR) variables on the significance of coronary lesions by the chi-square method, after which a diagnostic test was based on receiver operating curve (ROC) analysis. Study Result : There were 122 subjects and found that older age, male and smoking were more common in groups with significant coronary lesions. Cut off point for ∆QTcD is ≥13 ms with a sensitivity of 87,1% and specificity 85,2% and AUC 95,1%, while ∆QTdR ≥5.5% with sensitivity 85,7% and specificity 81,9% and AUC 90,5% are related to significancy of coronary lesion. Obtained subjects with significant lesions generally had a value of ∆QTcD ≥ 13 ms (p <0.001) and ∆QTdR ≥ 5.5% (p <0.001). Conclusion : The use of ∆QTdR dan ∆QTdR parameters as ECG variables, which are easily obtained in evaluating stress tests, can improve the diagnostic accuracy of exercise tests. In addition, evaluation of ∆QTdR dan ∆QTdR can provide information about the incidence of CAD. Keywords : ∆QTcD, ∆QTdR, Treadmill Exercise Test, Coronary Lession Significancy
PERANAN ELEKTROKARDIOGRAFI PADA HIPERTROFI VENTRIKEL KIRI Nikko Nugraha; Hauda El Rasyid
HUMAN CARE JOURNAL Vol 5, No 2 (2020): Human Care Journal Special Edition
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i2.732

Abstract

Hipertensi merupakan massalah kesehatan global dan faktor risiko utama morbiditas dan mortalitas penyakit kardiovaskular (PKV). Pemeriksaan baku emas untuk mendiagnosis HVK adalah dengan menggunakan ekokardiografi dan magnetic resonance imaging (MRI). Tidak semua fasilitas kesehatan mampu melakukan pemeriksaan ini dan mahal. Elektrokardiografi (EKG) merupakan pemeriksaan yang dimiliki hampir di semua fasilitas kesehatan. Pemeriksaan ini murah dan mudah untuk digunakan. tahun 2009, American Heart Association/American College Cardiology Fondation/Heart Rhythm Study (AHA/ACCF/HRS) mengeluarkan daftar 36 kriteria EKG untuk diagnosis HVK namun sensitivitasnya relative rendah. Tinjauan pustaka ini bertujuan untuk menjelaskan peranan EKG untuk memprediksi hipertrofi ventrikel kiri khususnya pada hipertensi.