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All Journal Journal of Social Research Jurnal Locus Penelitian dan Pengabdian
Mamasta, Khairuman Fitrah Ananda
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Aerospace Engineering Humanities Automotive Engineering Computer Science & IT Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Electrical & Electronics Engineering Mathematics Social Sciences

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Amiodarone, Extreme AV Block and Pseudo-Pacemaker Syndrome: A Malady Caused By A Cure Mamasta, Khairuman Fitrah Ananda; Sianturi, Agustina; Sarumpaet, Abigail Christine
Journal of Social Research Vol. 4 No. 8 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i7.2691

Abstract

Amiodarone is a potent antiarrhythmic that is used to treat supraventricular tachycardia (SVT). However, its substantial impact on atrioventricular (AV) nodal conduction can obscure or exacerbate underlying delays, resulting in rare conditions such as pseudo-pacemaker syndrome (PPMS). This syndrome is the result of an extreme prolongation of the PR interval, which results in AV dyssynchrony and hemodynamic compromise in the absence of an implanted device. A 25-year-old male presented with SVT, which was further complicated by hypokalemia. The case revealed a pre-existing AV nodal conduction delay. Therefore, we present the case. The patient transitioned to sinus rhythm after receiving amiodarone; however, they experienced a persistent and severe PR interval prolongation that exceeded 400 ms. The symptoms of vertigo and palpitations, which were consistent with PPMS, were induced by this severe conduction block and persisted for more than ten days, a reflection of the long half-life of amiodarone. This case concludes that amiodarone can dangerously exacerbate latent AV nodal disease in young adults, underscoring the necessity of recognizing PPMS as a clinical consequence of iatrogenic PR prolongation and emphasizing the need for cautious use and monitoring of antiarrhythmic drugs in patients with any evidence of conduction abnormalities.
Diagnostic Accuracy and Clinical Outcomes in Acute Coronary Syndrome of OMI/NOMI VS STEMI/NSTEMI: a Systematic Review Mamasta, Khairuman Fitrah Ananda; Sianturi, Agustina
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 11 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i11.5024

Abstract

Background: In the current STEMI-based model for diagnosing acute myocardial infarction (AMI), many patients classified as NSTEMI may actually have undetected acute coronary occlusion. As a result, these patients miss the opportunity for timely reperfusion therapy and experience worse outcomes than those with non-occlusive myocardial infarction (NOMI). To address this issue, a revised paradigm has been proposed that differentiates occlusion MI (OMI) from non-occlusion MI (NOMI). Methods: This systematic review included eight studies published between 2020 and 2024. All studies evaluated patients with acute coronary syndrome (ACS), comparing diagnostic performance and clinical outcomes between the traditional STEMI/NSTEMI paradigm and the emerging OMI/NOMI paradigm. The studies employed various designs, including retrospective cohorts, case-control analyses, and cross-sectional studies, to assess diagnostic accuracy and treatment outcomes. Results: Evaluation of ECG diagnostic performance showed that OMI-specific ECG patterns had significantly higher sensitivity (86%) and diagnostic accuracy (89%) compared to standard STEMI criteria (41% sensitivity, 77% accuracy). Several studies reported substantial delays in recognition and management of OMI when relying solely on STEMI criteria. Evidence consistently demonstrated that patients with OMI, especially those misclassified as NSTEMI, had outcomes equal to or worse than those with STEMI. Conclusion: The OMI paradigm highlights major quality gaps in the emergency care of ACS patients. Transitioning from the traditional STEMI/NSTEMI model to OMI/NOMI classification can improve diagnostic precision, identify care delays, and guide quality improvement interventions to optimize patient outcomes.
Co-Authors Sarumpaet, Abigail Christine Sianturi, Agustina