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  • Ekg & Aritmia

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    Muhaimin Efendi
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    This document discusses EKG and arrhythmias. It defines the normal pacemaker locations in the heart including the SA node, AV node, and Purkinje fibers. It describes atrial and ventricular depolarization times. Various QRS morphologies are defined. Methods for calculating heart rate from the EKG are provided. Causes of cardiac arrhythmias include disturbances in automaticity, conduction, or combinations. Key aspects for identifying arrhythmias are examining the QRS complex for regularity/irregularity and morphology, and the relationship between P waves and QRS. Specific arrhythmias discussed include PSVT, atrial fibrillation, atrial flutter, junctional rhythm, sinus rhythm with ectopic beats

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    ECG

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    This document discusses EKG and arrhythmias. It defines the normal pacemaker locations in the heart including the SA node, AV node, and Purkinje fibers. It describes atrial and ventricular depolarization times. Various QRS morphologies are defined. Methods for calculating heart rate from the EKG are provided. Causes of cardiac arrhythmias include disturbances in automaticity, conduction, or combinations. Key aspects for identifying arrhythmias are examining the QRS complex for regularity/irregularity and morphology, and the relationship between P waves and QRS. Specific arrhythmias discussed include PSVT, atrial fibrillation, atrial flutter, junctional rhythm, sinus rhythm with ectopic beats

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    29 views49 pages

    Ekg & Aritmia

    Uploaded by

    Muhaimin Efendi
    This document discusses EKG and arrhythmias. It defines the normal pacemaker locations in the heart including the SA node, AV node, and Purkinje fibers. It describes atrial and ventricular depolarization times. Various QRS morphologies are defined. Methods for calculating heart rate from the EKG are provided. Causes of cardiac arrhythmias include disturbances in automaticity, conduction, or combinations. Key aspects for identifying arrhythmias are examining the QRS complex for regularity/irregularity and morphology, and the relationship between P waves and QRS. Specific arrhythmias discussed include PSVT, atrial fibrillation, atrial flutter, junctional rhythm, sinus rhythm with ectopic beats

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 49

    EKG & ARITMIA

    SA node
    Sumber impuls normal/ alamiah , 60 100 x/m

    AV node
    Bisa mengeluarkan impuls 40-50x/menit

    Berkas His Serabut Purkinje

    Ventrikel
    Bisa mengeluarkan impuls 30 x/m

    Atrial Depolarization

    Ventricle Depolarization

    0.12 second

    Terminologi morfologi QRS qRs Rs R rS

    QR

    Q/QS

    RsR

    rSr

    5 kotak kecil = 1 kotak sedang = 0.2 detik 1 kotak kecil = 0.04 detik

    Paper speed : 25 mm/second

    5 kotak sedang = 1 kotak besar = 1 detik

    MENGHITUNG LAJU JANTUNG : A. Jarak R R : -1 kotak sedang -2 kotak sedang -3 kotak sedang -4 kotak sedang -5kotak sedang -6 kotak sedang = 300 x / menit = 150 x / menit = 100 x / menit = 75 x / menit = 60 x / menit = 50 x / menit

    B. Hitung jumlah R- R dalam 6 kotak besar = 6 detik Jumlah R x 10 = heart rate / menit
    C. 1500 / jarak R-R ( dlm mm ) = heart rate / menit

    Cause of cardiac arrhythmias : Disturbances in automaticity : bertambah cepat atau bertambah lambatnya suatu daerah otomatisiti. Misal di sinus node, AV node, abnormal beats/depolarisasi dari atrium, AV junction, ventrikel, VT, dll. Disturbances in conduction : konduksi terlalu cepat (WPW) atau terlalu lambat (blok AV). Combinations of altered automaticity and conduction.

    How to identify arrhythmias ? Treat the patient, not the monitor

    QRS complex Regular / irregular ?

    QRS complex Normal-looking QRS complex? Wide / narrow ?

    P wave ?

    Relationship between P and QRS ?

    PSVT :
    -due to re-entry mechanism -narrow QRS complex -regular -retrograde atrial depolarisation -P wave ?

    PSVT

    Atrial Fibrillation :
    -from multiple area of re-entry within atria -or from multiple ectopic foci -irregular, narrow QRS complex -very rapid atrial electrical activity (400-700 x/min). -no uniform atrial depolarisation

    Atrial Flutter :
    -The result of a re-entry circuit within the atria -irregular / regular QRS rate -Narrow QRS complex -Rapid P waves (300x/min), sawtooth

    Junctional rhythm:
    -AV junction can function as a pace maker (40-60 x/min). -due to the failure of sinus node to initiate timed impulse or conduction problem. -normal-looking QRS. -retrograde P wave. -P wave may precede, coincide with, or follow the QRS

    SR

    VES

    Sinus rhythm with multifocal VES

    VES

    VES

    SR

    SR

    SR

    SR

    SR

    SR

    Sinus rhythm with VES couplet

    Sinus Rhythm with VES, R on T

    1st degree AV block

    Prolonged PR interval

    2nd degree AV block, type 1

    Missing QRS

    Missing QRS

    2nd degree AV block, type 2

    Missing QRS

    Total AV Block / 3rd degree AV block

    QRS

    QRS

    QRS

    Treat the patient, not the monitor . . . . . . . . . .!!!

    Treat the patient, not the monitor . . . . . . . . . .!!!

    SELESAI

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