Surgical Room Research Articles

Hand Surgical Operating Room Size Allocation: A Comparative Space Utilisation Study.

Background: This study evaluated operating room (OR) space required for various hand surgical procedures. We analysed the size requirements for hand surgical cases divided into four settings: (1) large OR setting requiring fluoroscopy and microsurgical equipment, (2) medium-sized OR setting for cases requiring fluoroscopy, (3) smaller OR setting and (4) minor procedural room without anaesthesia with the aim to describe room size requirements for hand surgery practices. Methods: A variety of hand surgical cases were selected: large cases (microvascular digit replantation), medium-sized cases (closed reduction percutaneous pinning [CRPP] of phalangeal fractures) and smaller cases (carpal tunnel release [CTR]) with and without anaesthesia. Space requirements were compared to general surgery cases (laparoscopic appendectomy) and general orthopaedic surgery cases (cephalomedullary nail [CMN]). Necessary operative equipment was measured (ft2) to calculate requirements for each procedure. Results: Large hand cases such as digit replantation necessitated the most OR space (125 ft2), followed by general orthopaedic cases (CMN; 118 ft2), medium-sized hand cases (CRPP phalanx; 107 ft2), general surgery laparoscopic appendectomy (68 ft2), small hand cases (CTR; 85 ft2) and minor procedures (49 ft2). Conclusions: Hand procedures can be divided into major procedures requiring significant OR space (125 ft2), medium procedures in standard OR suites (107 ft2), procedures in small ORs with anaesthesia (81 ft2) or office-based setting without anaesthesia (49 ft2). These findings help define space utilisation for hand procedures and may have practical implications related to efficiency, cost and patient safety in the hospital and outpatient setting. Level of Evidence: Level IV (Economic and Decision Analyses).

Analisis dan Perbaikan Sistem Pencahayaan Buatan pada Rumah Sakit Tipe C di Kota Semarang dengan Menggunakan Simulasi Software Dialux Evo 11.1

<p><strong>The need for electrical energy is increasing due to population growth and the use of electrical equipment, including lighting systems or lamps. Lighting systems or lamps are important factors in creating a comfortable, safe and efficient atmosphere in the work environment, especially hospitals. Various methods have been used so that the lighting system or lamps can be optimized, for example by analyzing through Dialux Evo simulation. This study analyzes and improves the lighting system in a Type C hospital in Semarang using the Dialux Evo 11.1 simulation. The focus is on the nutrition or surgical polyclinic room and the operating room. The research method involves a comparison between the results of lighting strength measurements and simulations with the SNI 6197: 2011 standard. The measurement results show that the polyclinic room has an average lighting of 91.61 lux, while the simulation reaches 127 lux. For the operating room, the measurement produces 81.52 lux and the simulation 274 lux. Both of these rooms do not meet the minimum standards: 250 lux for the polyclinic room and 300 lux for the operating room. For the recommended improvements in the polyclinic room is the addition of 4 Philips LED-Tube 765 T8 AP C G light points or 5 Philips Downlight DN020B G3 D150 light points. While for the operating room, it is recommended to replace 14 points with Philips LED-Tube UO 16W865 T8 lights.</strong></p><p><strong><strong><em>Keywords</em></strong> - </strong><em>Lighting System, Strong Lighting, Dialux Evo 11.1, SNI 6197:2011</em></p>

Improving Performance in Surgical department through Communicating Information to Decision Makers: Intervention Study in a tertiary Hospital

Hospital performance evaluation is crucial for early detection of pitfalls, and problem-solving. Data shouldn’t be passively collected. They must be measured and understood through an underlying conceptual framework. Purpose: The General Surgical Department in collaboration with the Public Health Department had the objective of developing a module for periodic monitoring and evaluation of the eight general surgical units based on calculated key performance indicators (KPIs), Composite Indices (CIs) and communication of growing out information through policy briefs directed to the heads of units for better resources allocation and evidence based decision making. Methodology: An operations research using pre-post intervention design. The exploratory component was completed in six months in the 8 units of the department. Pretest service statistical data analyzed KPIs derived from hospital bed and surgical room utilization. Data were utilized for the calculation of 5 CIs for each unit. Study intervention included the development of policy briefs (PB) that were submitted to the head of the department. Informed decisions were made guided by the info-graph data in the form of traffic color coded ranking matrix to promote various services and to improve performance in the department units particularly lower ranked units. The post-test included reanalyzing of the service statistical data. Findings: Comparing pre-posttest figures revealed improvement in the calculated KPIs and CIs. Originality and practical implications: Bringing up a novel, feasible monitoring and evaluation model using refitted tools would support surgical unit heads in evidence-based decision-making and eventually improve performance efficiency.

Performance of an Autonomous Sanitary Sterilisation Ultraviolet Machine (ASSUM) on terminal disinfection of surgical theaters and rooms of an intensive-intermediate care unit

Ultraviolet- C (UV-C) light is effective for reducing environmental bioburden in hospitals, and the use of robots to deliver it may be advantageous. To evaluate the feasibility and clinical efficacy of an autonomous programmable UV-C robot in surgical and intensive care unit (ICU) rooms of a tertiary hospital. During ten consecutive months, the device was used in six theatres where cardiac, colorectal and orthopaedic surgeries were performed, and in the rooms previously occupied by patients subjected to contact precautions of a 14-bed ICU. Surgical site infection (SSI) rates of procedures performed in the UV-cleaned theatres were compared with those of the previous year. Incidence in clinical samples of ICU-acquired multiple-drug resistant (MDR) microorganisms was compared with that of the same period of the previous year. An UV-C exposure study done by semi-quantitative dosimeters and a survey of the bioburden on surfaces were carried out. SSI rates in the pre- and post-intervention periods were 8.67% (80/922) and 7.5% (61/813), respectively (p=0.37). Incidence of target microorganisms in clinical samples remained unchanged (38.4 vs. 39.4 per 10,000 patient-days, p=0.94). All the dosimeters exposed to ≤1 meter received ≥500 mJ/cm2. The bacterial load on surfaces decreased after the intervention, particularly in ICU rooms (from 4.57±7.4 CFU to 0.27±0.8 CFU, p<0.0001). Deployment of an UV-C robot in surgical and ICU rooms is feasible, ensures adequate delivery of germicidal UV-C light and reduces the environmental bacterial burden. Rates of surgical site infections or acquisition of MDR in clinical samples of critically-ill patients remained unchanged.

Anesthesia in Caesarean Section Patients with Hyperthyroid

Thyrotoxicosis is defined as a state of excess thyroid hormone and is not synonymous with hyperthyroidism, which is the result of excessive thyroid function. The prevalence of hyperthyroidism ranges from 0.2% to 1.3% in iodine-sufficient regions of the world. The combination of increasing FT4 and suppressing TSH is one way to enforce the hyperthyroidism diagnosis. The case of a 22-year-old woman with a diagnosis of G6P3A2H3 premature contractions has been reported , who came to the surgical room at Dr. HOSPITAL. Suhatman MARS to perform a caesarean section. Based on the pre-operative physical examination carried out, it was found that the patient's physical status was ASA II. In this patient, regional anesthesia will be planned. The patient has a history of hyperthyroidism since ± 10 years ago and regularly takes Thyrozol once a day during pregnancy and controls it with a specialist in Internal Medicine. Theoretically, this shows that the suspected condition of the patient is hyperthyroidism and if continued it could lead to Graves' disease, toxic nodular goiter, subclinical hyperthyroidism, or other conditions that lead to hyperthyroidism so surgery must be carried out taking this situation into account.

Management of Solid Medical Waste at Regional Public Hospital of West Papua Province

This study aims to characterize, identify and evaluate the management of solid medical waste in the West Papua Province Regional Public Hospital. This research is descriptive qualitative research conducted in December 2023 -January 2024 at the emergency room, obstetrics ward, pediatric ward, perinatology ward, surgical room, internal disease department and laboratory. The results research are the average amount of solid medical waste in West Papua Province Regional Public Hospital is 282.3 kg/month, consisting of infectious solid medical waste of 229 kg/month and the amount of infectious sharps medical waste of 53.3 kg/month. The process of solid medical waste management of hospitals in West Papua Province Regional Public Hospital has referred to the Government Regulation of the Republic of Indonesia Number 7 of 2019, although the results are not all appropriate.

Novel Surgical Technique for Total Knee Arthroplasty Integrating Kinematic Alignment and Real-Time Elongation of the Ligaments Using the NextAR System.

This study introduces an innovative surgical approach for total knee arthroplasty (TKA) that combines kinematic alignment (KA) principles with real-time elongation of the knee ligaments through the range of motion, using augmented reality (AR). The novelty of the surgical technique lies in the possibility of enhancing the decision-making process to perform the cut on the tibia as for the KA caliper technique developed by Dr. Stephen Howell. The NextAR is a CT-based AR system that offers the possibility of performing three-dimensional surgical preoperative planning and an accurate execution in the surgical room through single-use infrared sensors, smart glasses, and a control unit. During the preoperative planning, the soft tissue is not considered and only the alignment based on bony reference is ensured. Thanks to the possibility of measuring in real time the elongation of the knee collateral lateral ligaments, the system assists the surgeon in optimizing the cut on the tibia after an accurate resurfacing of the femur as described in the KA surgical technique. The implant used in this novel approach is a medial pivot design (Medacta GMK Sphere) that allows the restoration of the physiological behavior of the software tissue and natural knee kinematics. In conclusion, this novel technique offers a promising approach to TKA, allowing personalized treatment tailored to each patient's unique anatomy and soft tissue characteristics. The integration of KA and real-time soft tissue analysis provided by NextAR enhances surgical precision and outcomes, potentially improving patient satisfaction and functional results.

New Insight for Axillary De-Escalation in Breast Cancer Surgery: "SoFT Study" Retrospective Analysis.

Background: The SOUND study demonstrated that an axillary de-escalation may be sufficient in locoregional and distant disease control in selected early breast cancer (EBC) patients. To establish any preoperative variables that may drive sentinel lymph node biopsy (SLNB) omission, a study named sentinel omission risk factor (SOFT) 1.23 was planned. Methods: A single-center retrospective study from a prospectively maintained database was designed, aiming at underlying preoperative prognostic factors involved in sentinel lymph node (SLN) metastasis (lymph node involvement (LN+) vs. negative lymph node (LN-) group). Secondary outcomes included surgical room occupancy analysis for SLNB in patients fulfilling the SOUND study inclusion criteria. The institutional ethical committee Area Territoriale Lazio 2 approved the study (n° 122/23). Results: Between 1 January 2022 and 30 June 2023, 160 patients were included in the study and 26 (%) were included in the LN+ group. Multifocality, higher cT stage, and larger tumor diameter were reported in the LN+ group (p = 0.020, p = 0.014, and 0.016, respectively). Tumor biology, including estrogen and progesterone receptors, and molecular subtypes showed association with the LN+ group (p < 0.001; p = 0.001; and p = 0.001, respectively). A total of 117 (73.6%) patients were eligible for the SOUND study and the potential operating room time saved was 2696.81 min. Conclusions: De-escalating strategies may rationalize healthcare activities. Multifactorial risk stratification may further refine the selection of patients who could benefit from SLNB omission.

Gambaran Perilaku Caring Perawat pada Pasien Pre Operasi di Ruang Rawat Inap Bedah Rumah Sakit Palembang

Anxiety is a response given by an individual to a threat. The situation of a person who is waiting for an operation schedule shows an event that is full of uncertainty, it can cause fear and anxiety, it is necessary for nurses to apply caring behavior which is the focus of nursing practice. This study aims to determine the description of nurses' caring behavior for pre-operative patients in the surgical inpatient room at a hospital in Palembang. The research design used in this research is descriptive. The data collection technique was purposive sampling with a total of 79 respondents. From the research results, it was found that more nurses had positive caring behavior, namely 70 respondents stated that nurses' caring behavior was positive with a percentage of 88.6% and 9 respondents stated that nurses' caring behavior was negative with a percentage of 11.4%. The conclusion is that more nurses have positive caring behavior for preoperative patients in the Palembang Hospital Surgical Inpatient Room.

Impact of Updating Surgical Instrumentation Preference Cards on Operating Room Operations

Hospital systems across the United States have implemented quality improvement initiatives designed to mitigate unnecessary waste and decrease healthcare costs that are frequently passed on to patients. One key source of waste is excess sterile instrumentation in surgical operating rooms. This quality improvement project identified waste by auditing and updating surgical instrumentation preference cards (SIPCs) for the three most common procedures at a multi-center academic health system. Unnecessary items were recorded and savings calculated using 2022 supplier price data. Forty-nine procedures were audited, resulting in changes to 111 unique SIPCs. Although this process produced significant savings for the health system, it was limited to fewer than 10% of the total cases performed. Total savings were observed at $337,007 with savings of $56,254 for open instrumentation. A manual audit of all SIPCs across the institution and regular updates has the potential to decrease instrumentation waste and annual expenditures by approximately $4 million.

Control preoperative anxiety with self-relaxation

Anxiety experienced by preoperative patients is a normal response, but when the anxiety response causes disturbances in physiological and psychological function, this becomes an abnormal response. The impact of anxiety before surgery can have an impact on the operation so that it must be postponed. Action is needed to overcome the anxiety experienced by the patient. One that can by givingSelf relaxound therapy, that is by providing a combination of relaxation interventionsmaybeandnature sound developed by researchers which is done by perception and self-suggestion while listening to natural sounds and deep breathing exercises. The aim of this research is to determine the effect of relaxationself relaxound on patient anxiety before laparotomy surgery. This type of research uses quantitative research, by designquasi experiment using a non planequivalent without control group. This research was carried out in the surgical inpatient room on 32 respondents. Anxiety measurement uses a questionnaireZung Self Rating Scale. Data analysis usingPaired Sample T test with a significance limit of 0.05. The results of the analysis obtained a p value = 0.000 (α 0.05), which shows that there is a significant effect between therapyself relaxound with patient anxiety. Psychological problems are closely related to surgery, for this the researchers suggestSelf relaxound therapy can be considered as a nursing procedure for every preoperative patient.

Intraoperative Staff Radiation Exposure During Aortic Endovascular Procedures

The risk of radiation exposure in the surgical operating room (OR) and/or catheterization laboratory is now well established. Complex endovascular procedures often require multiple approaches and different positioning of the staff members around the patient, potentially increasing the levels of radiations exposure. Our goal was to evaluate the levels of radiation exposure of the members of the staff during endovascular aortic procedures in order to propose radioprotection optimization. We included 41 aortic endovascular procedures out of 114 procedures performed between January 12, 2014, and August 31, 2015, including 24 standard endovascular aortic aneurysm repair (EVAR), 7 EVAR with iliac branch (EVARib), 8 complex fenestrated/branched EVAR (F/B EVAR), and 2 thoracic EVAR (TEVAR). Procedures were performed in an OR equipped with a carbon fiber table and a mobile fluoroscopy C-arm. We collected the usual dosimetry data given by the C-arm as well as the patient's peak skin dose (PSD). In all staff members, radiation exposure was measured with thermoluminescent chip dosimeters placed on both temples, on posterior sides of both hands, and on both lower legs. PSD levels were low for EVAR because 24 patients had values below the reading threshold. PSD significantly increased with more complex procedures. Main operator (MO) received the higher level of irradiation on whole body, hands, and ankles. Eye lenses irradiation was higher on both assistant operators (AOs). Other members received low levels of irradiation. We found a high ranges of radiation exposure with a high risk of exposure for the AO, mainly for F/B EVAR and EVARib. Even if all personal protections are used, staff positioning is a major point that must be considered. If MO is supposed to be the most exposed to X-rays, specific conditions of positioning of the AO may be at risk of exposure.

Detection of pathogenic bacteria in the surgical rooms of Al-Ramady hospital using next generation sequencing

This study was aimed at applying the next generation sequence technique, to evaluate the microbial contamination of the General Al-Ramady Hospital and the diagnosis of dangerous types. Several surface swabs were taken from the surgical room devices and equipment used during the surgery period at the hospital. Hospital environment contributes chiefly to the emergence of Nosocomial infection, the most common and severe complications in the provision of health care to patients in the hospital, it has become necessary to specify and identify the causes of illness through alternative methods to traditional methods that waste time, money and effort.. The results showed contamination of hospital environment by several varieties of bacteria. They were pathogenic and nonpathogenic bacteria, in spite of the action of the Antiseptics used in sterilization. the most common of which were several types of Pseudomonas of 84.26% and Acinetobacter of 13.85%. The present of this pathogenic bacteria in hospital-related injuries, which are mean vital indicators of contamination in the hospital environment. Data suggest that it is possible to diagnose and identify the types of pathogenic, discover effective strategies for monitoring and controlling the hospital environment and providing the essential tools to avoid the spread of infection, particularly in the presence of the molecular technique.

The Factors Affecting Surgical Room Nurse's Compliance in Performing Sterile Handwashing in the Central Surgery Installation of RSUD Banyumas

Background: Surgical site infection, as a part of Healthcare-Associated Infections (HAIs), can be prevented by proper handwashing among the surgical team members. Compliance with handwashing has been proven to reduce healthcare associated infections. Method: This was quantitative research with a descriptive correlation design using a cross sectional approach. A total sampling technique was used with a sample size of 35 surgical room nurses’s in the central surgery installation of RSUD Banyumas who met the inclusion and exclusion criteria. The research instrument was aquestionnare. Data analysis was conducted using the chi-square test. Results: The study result show that the majority of nurses have good knowledge (45,7%), high motivation (77,1%), perceive good supervision (74,3%) and are compliant in performing sterile handwashing (71,4%). There is a correlation between knowledge, motivation and supervision with the compliance of surgical room nurses in performing sterile handwashing in the central surgery installation of RSUD Banyumas. Conclusion: Factor such as nurses knowledge and motivation in the surgical room and supervision from the department head are related to the compliance of surgical room nurses in performing sterile handwashing.

Factors Related to the Completeness of Electronic Surgical Safety Checklist Documentation in Banyumas Public Hospital

Background: Patient safety in surgery is a program established by the WHO and is a standard for accreditation by KARS, implementing the electronic surgical safety checklist. This has been proven to reduce patient safety incidents in the surgical room. Method: This quantitative research used a descriptive correlation design with a cross-sectional approach. A total sampling technique was employed, involving 34 surgical nurses in the Central Surgical Installation of RSUD Banyumas, who met the inclusion and exclusion criteria. The research instrument utilized an observation sheet based on the surgical safety checklist Standard Operating Procedure (SPO) at RSUD Banyumas. Data analysis was conducted using the chi-square test. Results: The results of the study revealed that the majority of nurses were male (70.6%), aged between 31-40 years (41.2%), and above 40 years (41.2%), with a DIII level of education (70.6%), and work experience of 1-5 years (44.1%), and they completed the electronic surgical safety checklist documentation (67.6%). Age, education level, and work experience correlate with the completeness of electronic surgical safety checklist documentation at RSUD Banyumas (p-value ? ?). Conclusion: Age, education level, and work experience related to the completeness of electronic surgical safety checklist documentation at RSUD Banyumas.

ANALYSIS OF SKIN SCARRING WITH PRE-, INTRA- AND DELAYED SURGICAL INJECTION THERAPY: THE PRECLINICAL RESEARCH

Purpose: Experimental testing of injection therapy in the area of the upcoming skin incision in order to improve the quality of achieving the aesthetic appearance of the skin scarring process. Materials and methods: The study was carried out on the skin of the sternum and anterior abdominal wall on 2 closely related minipigs.3 series of operations were carried out synchronously on two individuals in a surgical operating room with preliminary specific markings in the form of rectangles and trapezoids, respectively; the nipple-areolar complexes served as a guide for drawing the figures. At each stage, the same type of geometric marking of the surgical field was used and repeated interventions were performed in the same areas of injection therapy and biopsy sampling. In the postoperative period, on the 30th and 120th days, biopsy specimens were taken to verify the ongoing reparative processes based on clinical, photometric and histological analysis. Results: Preoperative injection therapy contributed to the formation of a normotrophic scar in structure closer to normal skin compared to a scar during normal tissue healing, which allows it to be recommended for preoperative preparation and for research in humans. The selected technique allows for assessment of the classic primary wound, with the introduction of saline and botulinum toxin intraoperatively and delayed at 1 and 4 months with histological analysis of the results. At each stage of the experiment, the team achieved long-term survival of minipigs without compromising their vital functions. The same type of geometric marking of the surgical field was used and repeated interventions were performed in the same areas of injection therapy and biopsy sampling. Conclusion: The methodology allows to assess different methods of linear scar formation with or without the use of injection therapy during surgical access, as well as comparing tissue adhesion histologically and optimal scar formation. When the effectiveness of BTA therapy is achieved, injection therapy requires further research under conditions of tissue deficit or tension during wound closure.

The development of an islamic nursing care model to improve patient satisfaction

Introduction: This study aimed to the development of an Islamic nursing care model to improve patient satisfaction. Methods: Cross-sectional design random sampling technique on 134 respondents, consisting of patients and nurses in the surgical inpatient room, internal medicine inpatient room, and postpartum and gynecology inpatient rooms, using simple random techniques. The variables of this study were the nursing factors, Islamic nursing care, and patient satisfaction and were collected using questionnaire. The data were collected using questionnaire in December 2021 at Islamic Hospital, Indonesia, and processed using a Smart Partial Least Squares (SmartPLS) analysis and Sommers' correlation test. Results: The Sommers' test results show significant relationship between nursing factor (nurse knowledge, nurse’s attitude, nurse competence, nurse personality) and patient satisfaction; nurse knowledge (p=0.000); nurse attitude (p=0.000); nurse competence (p=0.000); nurse personality (p=0.000; α&lt;0.05). SmartPLS test results show the nurse factor with Islamic nursing care has a strong significant influence (p value 0.000; β value 0.539; t value&gt; 1.96). Then for Islamic nursing care with patient satisfaction, it has a very strong significant effect (p value 0.000; β value 0.753; t value&gt; 1.96). Conclusions: Islamic nursing care as a mediator of nurse factors with patient satisfaction can be described in this study model because Islamic nursing care is a real form of care by nurses that is felt by the patient and the application of Islamic values so that the form of nursing care makes patients feel satisfied.

Outcomes of discoid excision and segmental resection for colorectal endometriosis: robotic versus conventional laparoscopy.

Surgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of robotic versus conventional laparoscopy for discoid excision and segmental resection. From 2019 to 2023, we conducted a retrospective cohort study of 152 consecutive patients with colorectal endometriosis who underwent robotic or conventional laparoscopy for discoid excision and colorectal resection. Ninety of the patients 152 underwent robotic surgery and 62 conventional laparoscopy. The mean total surgical room occupancy and operating times were longer in the robotic group: 270 ± 81min vs 240 ± 79min, p = 0.010, and 216 ± 78min vs 190 ± 76, p = 0.027, respectively. The mean intraoperative blood loss, and the incidence of intra- and postoperative complications (according to Clavien-Dindo classification) were similar in the two groups. The mean hospital stay was greater after conventional laparoscopy (8 ± 5 vs 7 ± 4days; p = 0.03), and the rate of persistent voiding dysfunction was higher in the conventional group (9/11, 25% vs 2/11, 5%; p = 0.01). A higher incidence of persistent voiding dysfunction was also observed after segmental resection by conventional laparoscopy (25% vs 4.8%, p = 0.01). Our results support the use of robotic surgery as an alternative to conventional laparoscopy for discoid excision and segmental resection for colorectal endometriosis.

Audio-Visual Therapy for Anxiety of Preoperative Patients Sectio Caesarea in the Central Surgical Installation Room of Ajibarang Hospital

Sectio Caesarea (SC) is a surgical procedure in labor that can cause anxiety. These feelings can occur due to fear of death, failed medication and complications. One of the therapies to reduce anxiety of SC preoperative patients with audio-visual therapy. This study aims to determine the effect of audio-visual therapy on the anxiety of SC preoperative patients in the Central Surgical Installation Room (IBS) of Ajibarang Hospital. The study used quantitative methods with experimental design in the form of pre-experimental design one group pretest-posttest. The sample was mothers who will undergo SC in the IBS Room of Ajibarang Hospital, a total of 30 respondents with purposive sampling techniques. The research instrument used the APAIS questionnaire. Data were analyzed using the Wilcoxon test. The results of the study obtained a p value of 0.000 &lt; 0.05, so it can be concluded that there are differences in the anxiety level of SC preoperative patients before and after audiovisual therapy in the IBS Room of Ajibarang Hospital. In conclusion, there are differences in the level of anxiety before and after audiovisual therapy is given to the anxiety level of SC preoperative patients in the IBS Room of Ajibarang Hospital.

An Overview Of The Level Of Occupational Stress Of Anesthesiologists In The Surgical Room Of The Hospital In The Banyumas District Area

Exercise can indeed improve the quality of health if it is done in accordance with the rules or program. However, excessive exercise without considering the capacity of the organs, especially the heart, can result in disease, one of which is heart disease, namely heart rhythm disturbances. The death rate for athletes in 2022 will still be at 29% during competition. In this case, it proves that Holter monitoring (ambulatory ECG monitoring) is better in assessing heart rhythm in athletes. Arrhythmias in athletes are caused by inadequate cardiac remodeling, causing ion channels in the atrioventricular node to undergo immunohistochemical labeling, where L-type calcium (Ca2+) channels that carry inward current are known to play a major role in the diastolic depolarization of the atrioventricular node, and regulate the excitability and increase in axis potentiation. . In the important Ca2+ channels in the heart, a slowing process occurs which results in a barrier to atrioventricular node conduction. A decrease in the axis action potential phase process where calcium cannot replace potassium in cells results in electrical impulse disturbances.