Articles
Very Fast Tachycardia: What is the mechanism?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 2 April - Juni 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i2.64
Seorang pria umur 59 tahun datang ke UGD Pusat Jantung Nasional Harapan Kita dengan keluhan berdebar sangat cepat disertai rasa sesak dan nyeri dada. Keluhan ini sudah dirasakan sejak 1 jam sebelum masuk rumah sakit. Pemeriksaan fisik terlihat keadaan umum sakit sedang tanpa tanda hipoperfusi. Tekanan darah 105/87 mmHg dengan denyut nadi sulit dihitung karena terlalu cepat. Pemeriksaan laboratorium dalam batas normal kecuali Rekaman EKG di UGD ditampilkan sebagai Gambar 1. Suatu takikardia QRS sempit regular dengan gambaran gelombang P di belakang kompleks QRS dapat merupakan suatu atrioventricular reciprocating tachycardia (AVRT), atrial takikardia/atrial flutter, atau atipikal atrioventricular node reentrant tachycardia (AVNRT). Bagaimana membedakan antara ketiga ke-mungkinan supraventrikular aritmia tersebut?
Dispersi Qt dan T-Wave Alternans pada Elektrokardiogram dengan repolarisasi Dini
Reza Octavianus;
Yoga Yuniadi;
Budhi Setianto
Jurnal Kardiologi Indonesia Vol. 33, No. 2 April - Juni 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i2.66
Background. It has been well known that early repolarization is only normal ECG variant without significant clinical consequences. However, recent studies show variable results of its relation to ventricular arrhythmias occurence. This study is aimed to seek corellation between early repolarization with more established ventricular arrhythmia marker.Methods. Corellation of early repolarization with QT dispersion and T wave alternans (TWA) in comparation with normal ECG pattern was conducted in a cross secional study. QT interval was measured using tangential methods. QT dispersion is defined as difference of longest and shortest QT interval in 12-lead ECG. TWA is determined by means of time domain modified moving average (MMA).Results. Twenty six subjects with early repolarization and 36 subjects with normal ECG participated in this study. Median age was 30 (20-49) years. Maximum TWA are 29. 5 (9 – 81) vs. 27 (5–81) (p= 0.493), and QT dispersion 20.4 (2.8–47.2) vs. 13.2 (2.4–46.0) ms (p=0.053) in early repolarization and normal ECG group respectively.Conclusion. No significant different of QT dispersion and TWA between subjects with early repolarization as compare to that with normal ECG.
Is Left-Sided Infective Endocarditis Prone to Have Embolic Events?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 1 Januari - Maret 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i5.71
Infective endocarditis (IE) is an endovascular microbial infection of intracardiac structures facing the blood including of large intrathoracic vessels and of intracardiac foreign bodies. Diagnostic and therapeutic improvement have been recently achieved, however it is still associated with high mortality and embolic events.A lot of studies have been done in search of high risk IE patient, mainly focus on echocardiographic findings. Unfortunatelly, those studies give rise conflicting results. In multicenter prospective European study, 384 consecutive patient with definite IE according to Duke criteria were followed up to 1 year. Using transesophageal echocardiography (TEE), they found that vegetation length is a strong predictor of new embolic event and mortality. In multivariate analysis, vegetation length of > 15 mm has an adjusted relative risk of 1.8 95%CI 1.1 to 2.82, p = 0.02. Combining clinical, microbiological and echocardiography finding may identify high risk patient who will need aggressive therapy.Stuby by Fahmi et al enrolled only limited number of definite IE patients and found that involvement of mitral valve, examined by transthoracal echocardiography (TTE), is a predictor of embolic events. As an initial study in this field among Indonesian subjects, we can compromize with the power of this study to conclude that left side valves involvement is a predictor of embolic event in IE patients. The conclusion it self is make sense in regard to the disease’s pathophysiology.
Ablasi Ventrikel Takikardia Outflow Tract
Erika Maharani;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 1 Januari - Maret 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i5.73
Tachycardia of right ventricular outflow tract (RVOT) is the most common cause of nonischemic ventricular tachycardia (VT). It is commonly due to idiopathic RVOT tachycardia. Idiopathic RVOT tachycardia is a nonfamilial and benign condition that occurs in young individuals without structural heart disease. Radiofrequency ablation has a high successful rate to eliminate this arrhythmia. Non contact mapping can be very helpful in patient with nonsustained tachycardias. We report the case of a 55-year-old man who presented with non sustained ventricular tachycardia and was successfully underwent radiofrequency ablation using non contact mapping.
Interferensi Elektromagnetik pada Pacu Jantung
Sefri Noventi Sofia;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 1 Januari - Maret 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i5.75
Increasing numbers of permanent pacemaker implantation in Indonesia raise the needs of electromagnetic interference (EMI) knowledge. EMI potentially result in pacemaker malfunction or failure that endangered the patient. This review discuss EMI sources that exist around patient daily live such as magnetic resonance imaging (MRI) examination, cellular phone, microwave oven, metal detector gate, elctrical cardioversion etc.
Terapi Sel Punca untuk Penyakit Jantung
Vireza Pratama;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 1 Januari - Maret 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i5.76
Despite a lot of advancesin current therapeutic modalities, heart failure and coronary artery disease are still the leading cause of morbidity and mortality. Current management of heart failure indeed increase survival rate, however re-hospitalization and mortality rate remain high. Furthermore, none of those therapeutic modalitiesare based on myocardial regeneration concept.Stem cell therapy is an interesting new concept in heart failure management. Various cell types, administration route and cell expansions strategies are extensively studied. Stem cell improve myocardial perfusion and differentiate into angiogenic and contractile cell. Stem cell therapy is a promising regeneratif medicine in the future.
Blok AV Mobitz II atau APC Bigeminy?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 33, No. 1 Januari - Maret 2012
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v33i5.78
Seorang perempuan 82 tahun dengan keluhan fatigue dirujuk ke poli aritmia untuk evaluasi lebih lanjut kemungkinan pemasangan alat pacu jantung menetap. Pemeriksaan fisik dalam batas normal. Rekaman EKG sebagaimana terlihat pada gambar 1.Gambaran EKG di atas memperlihatkan jarak interval PP yang tetap dengan gelombang P yang dikonduksikan ke ventrikel membentuk kompleks QRS (conducted) berselang seling dengan gelombang P yang tidak diteruskan ke ventrikel (non-conducted). Secara singkatrekaman EKG tersebut akan membawa pembaca pada diagnosis blok AV tipe Mobitz II.Blok AV tipe Mobitz II disebut juga blok AV derajat kedua tipe 2 ditandai dengan gambaran EKG yang menunjukkan gelombang P non-conducted yang intermiten tanpa didahului oleh pemanjangan interval PR dan tidak diikuti oleh pemendekkan interval PR. Umumnya letak blok berada di bawah nodal AV (infranodal). Oleh karena itu kompleks QRS pada Mobitz II hampir selalu memperlihatkan gambaran blok berkas cabang atau blok fasikular. Sebagian ahli mengelompokkan blok 2:1 ke dalam kelompok tersendiri yang tidak termasuk Mobitz I atau II karena hilangnya sifat intermiten blok yang biasanya terjadi pada Mobitz II.
Paradox Obesitas pada Pasien Gagal Jantung
Alvin Nursalim;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 32, No. 4 Oktober - Desember 2011
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v32i4.79
Obesitas sudah menjadi sebuah epidemi di negara maju. Ukuran objektif obesitas biasanya dinilai dari nilai IMT, dimana ukuran international untuk obesitas adalah IMT =30 kg/m2, sedangkan untuk ukuran orang Asia obesitas didefinisikan dengan nilai IMT=25 kg/m2.Obesitas memiliki hubungan yang erat dengan tingginya kejadian penyakit kardiovaskular. Obesitas dapat meningkatkan kadar trigliserid yang buruk untuk kesehatan jantung dan menurunkan kadar high density lipoprotein (HDL) yang bersifat kardioprotektif. Selain itu, seiring meningkatnya obesitas, meningkat juga angka hipertensi. Obesitas juga dapat menyebabkan disfungsi diastolik dan berhubungan dengan memburuknya fungsi sistolik.Walaupun obesitas merupakan faktor risiko penyakit jantung koroner, hal yang berbeda ditemukan pada kasus gagal jantung. Berdasarkan beberapa studi, pasien gagal jantung dengan Indeks Masa Tubuh (IMT) yang lebih tinggi memiliki prognosis yang lebih baik dibandingkan mereka dengan IMT yang lebih rendah. Selain itu, analisis dari beberapa studi oleh Oreopoulos et al menyimpulkan bahwa IMT yang lebih tinggi berhubungan dengan prognosis yang lebih baik pada pasien gagal jantung. Hal inilah yang disebut paradox obesitas (Obesity paradox).
Fibrilasi Atrial Selama Perawatan Infark Miokard Akut Merupakan Prediktor Stroke Jangka Panjang
Manoefris Kasim;
Octavia Lilyasari;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 32, No. 4 Oktober - Desember 2011
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v32i4.82
Background. Atrial fibrillation (AF) is a common arrhythmia after acute myocardial infarction (AMI).Mortality in AMI patients with AF also been shown to be up to twice as high as for those without AF. Non hemorrhagic stroke occurs in 0.1% to 1.3%of patients with acute myocardial infarction who are treatedwith thrombolytic, with substantial associated mortality and morbidity. The aim of this study is toelaborate correlation between in hospital AF with long term stroke event inST-elevation myocardial infarction (STEMI) patients who treated with thrombolytic.Methods. Two hundred and thirty STEMI patients (27-72 yo) treated with thrombolytic agent were studied retrospectively. The study end point was Major Cardio-Cerebrovascular Event (MACCE) during 3 years follow up. Results. Eleven patients experience AF episode during STEMI hospitalization. During 3 years follow up 24 patients (10.4%) experienced MACCE which comprised of : cardiac death 4 (1.7%), fatal infarction 2 (0.9%), non fatal infarction 13 (5.7%) and stroke 5 (2.2%). Independent clinical variables were not significant as a predictor for the occurrence of future stroke event, except atrial fibrillation episode (HR 13.4; p<0.005) that was encountered during hospitalization in the setting of AMI.Conclusion. In-hospital AF in STEMI patients treated with thrombolytic agent is a predictor of long term stroke.
Implantasi CRT pada Pasien dengan Katup Thebesian Prominen
Erwin Mulia;
Wenny Fitrina Dewi;
Erika Maharani;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 32, No. 4 Oktober - Desember 2011
Publisher : The Indonesian Heart Association
Show Abstract
|
Download Original
|
Original Source
|
Check in Google Scholar
|
DOI: 10.30701/ijc.v32i4.84
CRT has been established as standard treatment for refractory heart failure in many major clinical trials. Insertion of left ventricle lead is frequently most challenging step. Coronary sinus anatomy is of the most technical burden. A case of CRT implantation with presence of prominent Thebesian valve and stenotic posterolateral vein is presented in thic case report.