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Study of Machine Learning Algorithm on Phonocardiogram Signals for Detecting of Coronary Artery Disease Satria Mandala; Miftah Pramudyo; Ardian Rizal; Maurice Fikry
Indonesia 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

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.

Predictors of Appropriate Shocks and Ventricular Arrhythmia in Indonesian with Brugada Syndrome Ardian Rizal; Sunu Budhi Raharjo; Dicky Armein Hanafy; Yoga Yuniadi
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.v40i2.767

Background : Brugada syndrome is an inherited disease characterized by an increased risk of sudden cardiac death owing to ventricular arrhythmias in the absence of structural heart disease. It has been reported that this syndrome is more prevalent in South-East Asia than in Western countries. Furthermore, genetic studies showed important contributions of several gene mutations to the phenotype of BrS. These suggest that ethnic difference play significant roles in the pathogenesis of BrS. In addition, ICD implantation remains the cornerstone management with a low rate of appropriate shocked. Therefore, it is important to investigate patientsâ€™ characteristics for risk stratification. Our objective to investigate the clinical, electrocardiography (ECG) and electrophysiological characteristics that can be used as predictor of appropriate shock due to ventricular arrhythmia (VA) in Indonesian patients with BrS. Methods : We analyse data from Brugada syndrome registry at National Cardiovascular Centre Harapan Kita since January 2013. Total 22 patients were included. Characteristics of BrS that we analysed were baseline characteristics (age and sex), Clinical finding (syncope, cardiac arrest), ECG finding (spontaneous type 1 or drug induced) and Electrophysiology study result (inducible VA and RV ERP). We also added some new ECG characteristic (S wave in lead 1, S wave duration in V1, Fragmented QRS, Junction ST elevation and early repolarization pattern in infero-lateral) to be analysed. Our end point are appropriate shock during ICD interrogation for those who have been implanted an ICD, and documented VA for those who didnâ€™t receive ICD. Result : We found high incidence of appropriate ICDâ€™s shock in our population (50% in our study vs 5-11.5% in real world). Predictors of appropriate shock and documented VA are history of syncope (p = 0.045; OR 2.57 [1.44-4.59]), spontaneous type-1 ECG (p = 0.005) and right ventricular effective refractory period (RV ERP) of <200 ms (p=0.018). Other parameters that have been reported to correlate with the occurrence of VA (S Wave in lead 1 (p = 0.530), early repolarization pattern (p = 0.578), fragmented QRS (p = 0.601), S Wave duration (p = 0.365) and J Point STE (p = 0.800) were found to be not correlated to appropriate shock in our populations. Conclusion : History of syncope, spontaneous type-1 Brugada ECG and RV ERP of <200 ms have predictive values for risk stratification of Indonesian patients with Brugada syndrome. Keywords : Brugada Syndrome, Ventricular arrhythmia, ICD shock

Effects of Red Galangal Rhizome Extract (Alpinia purpurata) as an Inhibitor of Staphylococcus aureus Bacterial Biofilm Sri Winarsih; Ardian Rizal; Ratu, Estyka
Eureka Herba Indonesia Vol. 4 No. 4 (2023): Eureka Herba Indonesia
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ehi.v4i4.96

Staphylococcus aureus is a type of bacteria that causes infection through the virulence mechanism of biofilm formation, namely forming a layer by removing the matrix as a form of defense from the immune system and from antibacterial agents. This bacterium makes it very easy to form biofilms, thereby reducing the effectiveness of therapy with antibiotics. Red galangal is a spice plant that grows a lot in Indonesia. It is known to contain flavonoids, tannins, and terpenoids, which are thought to have activity in inhibiting biofilm formation. This study aimed to determine the effect of red galangal rhizome extract in inhibiting the formation of biofilms of Staphylococcus aureus bacteria. The method used is the test tube method using crystal violet dye. The results of the tube test method were photographed and quantified into the mean gray value (MGV) found in the Adobe Photoshop CS6 application. The thicker the biofilm is indicated by the lower the MGV value. Red galangal extract was obtained by maceration using 96% ethanol solvent, while the extract concentrations for treatment were 50%, 25%, 12.5%, 6.25%, 3.125%, 1.56%, and 0%. The results of statistical analysis showed that the higher the concentration of the extract, the thinner the biofilm ring formed (Pearson correlation, r = -0.980, p = 0.000). In conclusion, the ethanol extract of red galangal rhizome has the potential to inhibit Staphylococcus aureus biofilm formation with minimal biofilm inhibition at a concentration of 12.5%.

The effect of fluid restriction monitoring guidelines using the Heart Failure Self-Care Application (Aplikasi Perawatan Mandiri Heart Failure/ATRIA) on reducing risk of fluid retention in heart failure patients at Dr. Saiful Anwar Hospital Malang Ghazyarda Aqilah Setya; Mifetika Lukitasari; Suryanto; Ika Setyo Rini; Hikmawan Wahyu Sulistomo; Cholid Tri Tjahjono Candra; Mohammad Saifur Rohman; Ardian Rizal
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.13534

Heart failure patients are often at risk of rehospitalization due to recurrent symptoms such as dyspnea, edema, pulmonary congestion, and rapid weight gain resulting from fluid retention. This study aimed to analyze the impact of guided fluid restriction using the ATRIA application on risk of fluid retention in heart failure patients. The quasi-experimental method was used with a posttestonly control group design. Simple random sampling was carried out to select respondents, with the intervention group given the ATRIA application and the control group receiving a booklet intervention. The study duration was four weeks, with 16 respondents in the intervention group and 15 respondents in the control from Dr. Saiful Anwar Hospital, Malang. Data analysis used an independent sample t-test to assess differences in body and weekly weight changes. The resultsshowed no significant difference in body weight between the intervention and control groups each week (p > 0.05). Similarly, there was no significant difference change in body weight between the two groups (p > 0.05). In conclusion, there is no distinction observed between the ATRIA application and booklet concerning fluid restriction guidelines for reducing risk of fluid retention in heart failure patients. The results suggested that nurses could provide educational services and monitor the condition of heart failure patients using either application or booklet. Future studies are recommended to analyze factors that might impact fluid retention in heart failure patient.

Unprovoked transformation of saddle back to coved ST-segment elevation ECG pattern Firdaus, Muhammad; Ardian Rizal
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.2025.006.01.23

Background Brugada syndrome (BrS) is a heritable arrhythmia that is clinically characterized by spontaneous coved ST segment elevation and a negative T wave in the right precordial lead. Some psychotropic medications, anesthetics, cocaine, excessive alcohol consumption, and fever have been identified as potential causes of VF and SCA in BrS. Case Illustration A 35-year-old man was hospitalized after experiencing unexplained syncope. It was felt 3 times within an hour and was preceded by lightheadedness, nausea, and vomiting. He did not experience palpitations, chest pain, or shortness of breath prior to the syncope. Prior to syncope, he had no history of fever, dehydration, drinking, or taking any medications. There was no family member died suddenly because of heart disease. The physical examination, CXR, laboratorium, and echocardiography were all within the normal range, but the electrocardiogram showed a coved ST segment elevation with an inverted T wave at V1-V2, as well as a saddle back ECG pattern two weeks later with a J point of 2 millimeters at V2. The combination of symptoms and ECG findings led to the BrS diagnosis. He underwent ICD implantation at RSUD Dr Saiful Anwar Malang for secondary prevention. After several months of ICD check-ups, there were no VT/VF events or ICD shock therapy. Conclusion A change in the ecg of the brugada pattern from type 2 to 1 is often accompanied by known ethiologies. But an unprovoked conversion of the BrS type is possible in rare cases.

A follow-up approach to manage tachyarrhythmia and bradyarrhythmia in Ebstein’s anomaly patient Setyowati, Danti Utami; Ardian Rizal
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.2025.006.01.17

Background: Ebstein’s Anomaly (EA) is a rare heart defect that can cause a number of problems, including arrhythmias. They exhibit a greater rate of recurrence compared to those with normal hearts. High-definition (HD) mapping and three-dimensional (3D) ablation are new techniques that may be suboptimal, attributed to anatomical characteristics. The management tactics employed may necessitate modification in accordance with personal traits. Case Report: A 37-year-old male presented with intermittent palpitations over years. The electrocardiogram (ECG) is changing overtime such as supraventricular tachycardia (SVT), ventricular tachycardia (VT) and atrial fibrillation (AF). Echocardiography shown typical features of EA. During ablation, multiple atrial tachycardias were induced. Throughout the observation period, the patient exhibited complications related to several arrhythmia recurrence. In the end he suffered from total atrioventricular block (TAVB), leading to the decision to undergo a permanent pacemaker procedure. We postulated that specific characteristics of the right atrioventricular groove structure observed in pathological samples of EA could explain less than ideal results in ablation procedures. Conclusion: Managing arrhythmia in EA could be challenging. A prominent ridge alongside the lower atrioventricular groove is a typical characteristic in EA, and is associated with the clinical background of accessory pathways (AP). Understanding this anatomical aspect is important for electrophysiologists who work with this group of patients, since their management approaches may need to be adjusted.

Unprovoked transformation of saddle back to coved ST-segment elevation ECG pattern Firdaus, Muhammad; Ardian Rizal
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.2025.006.01.23

Background Brugada syndrome (BrS) is a heritable arrhythmia that is clinically characterized by spontaneous coved ST segment elevation and a negative T wave in the right precordial lead. Some psychotropic medications, anesthetics, cocaine, excessive alcohol consumption, and fever have been identified as potential causes of VF and SCA in BrS. Case Illustration A 35-year-old man was hospitalized after experiencing unexplained syncope. It was felt 3 times within an hour and was preceded by lightheadedness, nausea, and vomiting. He did not experience palpitations, chest pain, or shortness of breath prior to the syncope. Prior to syncope, he had no history of fever, dehydration, drinking, or taking any medications. There was no family member died suddenly because of heart disease. The physical examination, CXR, laboratorium, and echocardiography were all within the normal range, but the electrocardiogram showed a coved ST segment elevation with an inverted T wave at V1-V2, as well as a saddle back ECG pattern two weeks later with a J point of 2 millimeters at V2. The combination of symptoms and ECG findings led to the BrS diagnosis. He underwent ICD implantation at RSUD Dr Saiful Anwar Malang for secondary prevention. After several months of ICD check-ups, there were no VT/VF events or ICD shock therapy. Conclusion A change in the ecg of the brugada pattern from type 2 to 1 is often accompanied by known ethiologies. But an unprovoked conversion of the BrS type is possible in rare cases.

A follow-up approach to manage tachyarrhythmia and bradyarrhythmia in Ebstein’s anomaly patient Setyowati, Danti Utami; Ardian Rizal
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.2025.006.01.17

Background: Ebstein’s Anomaly (EA) is a rare heart defect that can cause a number of problems, including arrhythmias. They exhibit a greater rate of recurrence compared to those with normal hearts. High-definition (HD) mapping and three-dimensional (3D) ablation are new techniques that may be suboptimal, attributed to anatomical characteristics. The management tactics employed may necessitate modification in accordance with personal traits. Case Report: A 37-year-old male presented with intermittent palpitations over years. The electrocardiogram (ECG) is changing overtime such as supraventricular tachycardia (SVT), ventricular tachycardia (VT) and atrial fibrillation (AF). Echocardiography shown typical features of EA. During ablation, multiple atrial tachycardias were induced. Throughout the observation period, the patient exhibited complications related to several arrhythmia recurrence. In the end he suffered from total atrioventricular block (TAVB), leading to the decision to undergo a permanent pacemaker procedure. We postulated that specific characteristics of the right atrioventricular groove structure observed in pathological samples of EA could explain less than ideal results in ablation procedures. Conclusion: Managing arrhythmia in EA could be challenging. A prominent ridge alongside the lower atrioventricular groove is a typical characteristic in EA, and is associated with the clinical background of accessory pathways (AP). Understanding this anatomical aspect is important for electrophysiologists who work with this group of patients, since their management approaches may need to be adjusted.

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