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"Tujuan. Memperjelas gelombang P untuk mempertajam diagnosis aritmia, menggunakan semprit-larutan garam (SLG) sebagai konektor/konduktor elektrode eksplorasi guna merekam elektrogram venasentral (EGV), pada pasien pascabedah jantung terbuka.Tempat. Unit perawatan intensif bedah pada Pusat Kesehatan Jantung Nasional. Subyek. Pasien pascabedah jantung terbuka yang telah dipasangi elektrode epikardial-atrium-kanan dan kateter venasentral.Metode. Kateter venasentral setiap pasien dihubungkan dengan semprit kacalogam 20 ml hydrosalphyngograph-Riester yang berisi larutan NaCl 3% (sempritlarutan garam). Elektrogram atrial (EGA), EGV (SLG) dan elektrokardiogram (EKG) konvensional sandapan dada, direkam secara simultan menggunakan alat elektrokardiograf 3-saluran (V1-2-3). Dua dokter terpisah mengukur tingginya gelombang atrial/P dan 2 kardiolog terpisah membuat diagnosis aritmia. Jika terjadi perbedaan diagnosis aritmia, seorang kardiolog lain bertindak sebagai validator. Dengan titik potong tinggi gelombang (peak to peak) 0,5 mm, EGV (SLG) dan EKG dibandingkan dengan EGA sebagai baku emas.Hasil. Studi populasi yang terdiri dari 192 pasien berturutan pascabedah jantung terbuka dari Juli 1995 sampai Maret 1997 (n = 1997 pasien). Dalam mendeteksi adanya gelombang P berdasarkan EGA sebagai baku emas, EGV (p = 0,5) lebih sensitif (sensitivitas = 98,9%) dibandingkan dengan EKG konvensional (p = 0,001; sensitivitas = 84,2%), terjadi peningkatan sensitivitas sebesar 14,7% (98,9% - 84,2%). Pada diagnosis aritmia, EGV (SLG) lebih sensitif dari EKG (0,995; 98,7% dibandingkan 0,001; 78,5%), terjadi peningkatan sensitivitas sebesar 20,2% (98,7% - 78,5%).Kesimpulan. EGV (SLG) memperjelas gelombang P dan meningkatkan sensitivitas deteksi aritmia pascabedah jantung terbuka.

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Objectives. To enhance P waves in order to improve the diagnosis of arrhythmia, central venous electrogram (CVEG) using salt-solution syringe procedure, as a potential (connector/conductor) exploring lead, was performed in patients who underwent open heart surgery.Setting. Surgical Intensive Care Unit of the National Cardiac CenterSubjects. After open heart surgery patients in whom the epicardial-right-atrial wire electrode and central venous catheter were installed.Methods. The central venous catheter from each patient was connected with a 20-ml hydrosaiphyngograph-Riester glass-metal syringe containing 3% NaCl solution (salt-solution syringe ). Atrial electrogram (AEG), CVEG using salt-solution syringe procedure, and conventional chest lead ECG were recorded simultaneously using 3-channel (V1-2-3) electrocardiograph machine. Two doctors who were blinded in manner analyzed the recorded atrial (P) waves and 2 cardiologist confirmed the diagnosis of arrhythmia from all patients. If a different diagnosis occurred, the other cardiologist would act as validator. With the cut-off point of 0.5 mm, identification of peak to peak P waves in CEVG using salt-solution syringe and ECG were compared with AEG as a gold standard.Results. The study population consisted of 192 cosecutive patients after open heart surgery from July 1995 to March 1997 (n = 1997 patients). In detecting the presence of P wave, comparing to-the AEG as a gold standard, CVEG using salt-solution syringe procedure (p = 0.5) is more sensitive (sensitivity = 98.9%) than conventional ECG (p = 0.001; sensitivity = 84.2%), increases the sensitivity by 14.7% (98.9% - 84.2%). In the diagnosis of arrhythmia, CVEG using salt solution syringe procedure is more sensitive than ECG (0.995; 98.7% vs 0.001; 78.5%), increases the sensitivity by 20,2% (98.7% - 78.5%).Conclusions. CVEG using salt-solution syringe procedure significantly amplifies P waves and improves the sensitivity in detecting arrhythmia after open heart surgery.;Objectives. To enhance P waves in order to improve the diagnosis of arrhythmia, central venous electrogram (CVEG) using salt-solution syringe procedure, as a potential (connector/conductor) exploring lead, was performed in patients who underwent open heart surgery."

"Lima puluh persen penderita gagal jantung merupakan gagal jantung dengan fraksi ejeksi yang normal (HFPEF). Morbiditas dan mortalitas HFPEF belumlah jelas. Latihan olahraga telah menjadi rekomendasi pertama dalam beberapa panduan klinis, namun belum pada HFPEF. Strain longitudinal apikal 4 ruangan dapat digunakan sebagai nilai prognostik. Perbaikan fungsi longitudinal intrinsik ventrikel kiri menggunakan strain longitudinal apikal empat ruangan akibat latihan olahraga belumlah diketahui. Kuasi eksperimental menggunakan 30 sampel konsekutif HFPEF, dilakukan program latihan olahraga tersupervisi. Program latihan olahraga dilakukan selama satu bulan. Dilakukan pemeriksaan ekokardiografi, 6MWT, kuesioner MLWHF dan WHO. Terdapat perbedaan yang signifikan dalam 6MWT, nilai skoring MLWHF dan WHO5 sebelum dan sesudah latihan olahraga. Didapatkan nilai strain longitudinal sebesar -16,20% (-10,7% sampai dengan -17,81%). Strain longitudinal apikal 4 ruangan mengalami perbaikan pada minggu ke 2 dan ke 4 latihan olahraga (sebelum latihan olahraga LS = -16,20 [-10,70 to -17,81]; minggu ke dua latihan olah raga LS = -18,00±2,69 dan minggu ke 4 latihan olahraga LS = -21,86±1,79) dan terdapat perbedaan yang signifikan (p < 0,001). Terdapat perbaikan fungsi intrinsik longitudinal ventrikel kiri sebelum dengan sesudah diberikan program latihan olahraga pada penderita gagal jantung dengan fraksi ejeksi yang normal.

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Fifty percent of patients with heart failure are heart failure with preserved ejection fraction (HFPEF). Morbidity and mortality of HFPEF is unclear. Exercise has become the first recommendation in several clinical guidelines, but not yet in HFPEF. Apical 4 chamber longitudinal strain can be used as a prognostic value. But the improvement of longitudinal intrinsic left ventricular function using apical 4 chamber longitudinal strain due to exercise training is not yet known. Quasi- experimental study using thirty consecutive sample of HFPEF. Exercise training program was conducted for a month. Echocardiography, 6MWT, MLWHF and WHO questionnaire was performed before and after exercise. There was significant differences in the 6MWT, the value of MLWHF and WHO5 score before and after exercise. Longitudinal strain values obtained by -16.20 % (-10.7% to -17.81%). Four chamber longitudinal strain was improved at weeks 2 and 4 of exercise (before exercise LS = -16.20[-10.70 to -17.81]; the second week of exercise training LS = -18.00±2,69 and week 4 exercise LS = -21.86 ± 1.79) and there were significant differences (p < 0.001). There was an improvement in the longitudinal intrinsic left ventricular function before and after exercise training in patients with heart failure with preserved ejection fraction."