HOW TO READ

ELECTROCARDIOGRAPHY

Department of Internal Medicine

Faculty of Medicine Chrisitan University of Indonesia
Kurniyanto, MD

ECG INTERPRETATION
1.
2.
3.
4.
5.
6.

RATE
RHYTHM
AXIS
HIPERTROPHIC SIGNS
MYOCARDIAL INFARCTION
ARRHYTHMIA

Pola Membaca EKG

Irama
Rate QRS
Aksis QRS
Morfologi Gelombang P
Interval PR
Durasi QRS
Morfologi QRS
Deviasi Segmen ST
Morfologi Gelombang T
Morfologi Gelombang U
Lain-lain (LVH,LV Strain,BBB,
QT interval)
Kesimpulan EKG

Nilai Normal :
Interval PR

0,12 s/d 0,20

Durasi QRS

0,04 s/d 0,12

Aksis Normal

- 300

s/d + 1100

1. RATE
Normal heart rate : 60 100 x/minutes
> 100 x/minutes : Sinus Tachycardia
< 60 x/minutes
: Sinus Bradicardia

Determination heart rate (normal paper speed 25 mm/s):

300
Count number of large square (bold boxes in one R R interval)

1500
Count number of small square in one R R intervals

Number of QRS complex in 6 seconds, multiply by 10

2. RHYTHM
Normal cardiac rhythm : SINUS rhythm
Sinus rhythm characteristics :
Rate 60-100 bpm
Constant R R interval
Negative P wave in aVR and positive di II
P wave is always followed by QRS complex

3. AXIS

4. HYPERTROPHIC SIGNS

5. MYOCARDIAL INFARCTION
Ischemia
Injury
Necrosis

ANTERIOR INFARCTION

INFERIOR INFARCTION

POSTEROLATERAL INFARCTION

ARRHYTHMIA

AV BLOCK

WHATS WRONG??
Lead Error: V1 and V3 are Transposed!
In this normal 12-lead ECG the V1 and V3 chest electrodes are
interchanged. Experienced ECG interpreters should be able to spot this
lead placement error.

DISCUSSION

Sinus arrhythmia

Limb lead reversal

Early repolarization

Subendocardial ischemia.
Anterolateral ST-segment depression

Unstable angina

acute anterolateral myocardial infarction

High lateral infarction

Lateral myocardial infarction

Right ventricular infarction

Acute inferoposterior myocardial infarction

left ventricular aneurysm

Mobitz I

High-grade atrioventricular block

Wolff-Parkinson-White syndrome

Wolff-Parkinson-White syndrome

Atrial fibrillation

Atrial flutter

premature ventricular contraction

Supraventricular tachycardia

Wide complex tachycardia

Ventricular flutter

Idioventricular rhythm