HOW TO READ

ELECTROCARDIOGRAPHY

Ns. Devi Darliana, M.Kep., Sp.MB

Unipolar Precodial (Chest) Leads
Midclavicular line
Anterior axillary line
Midaxillary line

V6R V6
V5
V5R
V4
V4R V3
V3R V2
V1

Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
Unipolar Precodial (Chest) Leads

Horizontal plane of V4-6

V7 V8 V9 V9RV8RV7R

Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
Gambaran EKG Normal
 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) Nilai Normal :
 Kesimpulan EKG Interval PR 0,12’’ s/d 0,20’’
Durasi QRS 0,04’’ s/d 0,12’’
Aksis Normal - 300 s/d + 1100
1. 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
2. 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
3. HYPERTROPHIC SIGNS
4. MYOCARDIAL INFARCTION

 Ischemia
 Injury
 Necrosis
PERUBAHAN SEGMEN ST
ARRHYTHMIA
Sinus arrhythmia
Subendocardial ischemia.
Anterolateral ST-segment depression
acute anterolateral myocardial infarction
Lateral myocardial infarction
Acute inferoposterior myocardial infarction
AV BLOCK
Mobitz I
Left bundle branch block
Right bundle branch block
Atrial fibrillation
Atrial flutter