Acute results of permanent pacemaker implantation in Cipto Mangunkusumo General Hospital, Jakarta.

AIM: To investigate the acute results (parameters at implant and clinical parameters) of permanent pacemaker implantation at our institution. METHODS: Twenty five patients undergoing pacemaker implantation were included in this study. Subjects underwent medical history and functional class was assessed using New York Heart Association (NYHA) classification. All technical parameters (pacing threshold, sensing, and pacing impedance) and clinical parameters (complication and procedure time) were measured during and post implant. RESULTS: Majority (80%) of patients were in NYHA functional class II. The commonest indication for pacemaker implant was the complete heart block (56%). The most frequent pacemaker type was single chamber (80%) with the commonest pacing mode of VVIR (72%). Average optimal parameters achieved were pacing threshold of 0.5 volt, sensing of 12.6 mV, and impedance of 829 Ohm. Average procedure time was 1.6 hour. Major complication (pocket infection) was noted in only one patient. CONCLUSION: It is confirmed from this study that permanent pacemaker implantation could be carried out safely and effectively with low complication rate in a general hospital. Optimal pacing parameters could be achieved in the acute phase. Most patients still could not afford appropriate pacing devices due to limited financial support. Government insurance coverage for the poor should be encouraged to cover more people.

The correlation between free thyroxine levels and left ventricular mass in Graves' disease.

AIM: to determine the correlation between free thyroxine level and left ventricular mass in newly diagnoses Graves' disease. METHODS: seventeen patients with newly diagnosed Graves' disease were studied. Inclusion criteria was new case of Graves' disease, no previous history or clinical evidence of coronary artery disease, cardiac valve disease, diabetes mellitus, chronic kidney disease, not taking antithyroid drugs and any drugs that could affect the heart (beta blockers, ACE inhibitor). Echocardiographic indices of left ventricular mass was obtained. RESULTS: there were no correlation between free thyroxine levels and left ventricular mass, systolic and diastolic blood pressure. There was a correlation between pulse rate and left ventricular mass in Graves' disease. CONCLUSION: there was no correlation between free thyroxine level and left ventricular mass in Graves' disease.