Electrocardiography

Ahmad Adityawarman
• 1 kotak kecil = 1 mm
= 0,04 s (horizontal)  durasi
= 0,1 mV (vertikal)  amplitudo
Gelombang P
Interval PR
 Kompleks QRS

• Durasi normal: 0,10 s (2 ½ kotak kecil)

Segmen ST
 Gelombang T
• Mengikuti arah
gelombang QRS
sebelumnya
• Dapat inverted pada III &
V1
• Tidak ada kriteria untuk
lebarnya
• Tingginya harus > 1/8 dan
< 2/3 gelombang R,
jarang > 10 mm
 Interval QT

• Durasinya harus 0,35 – 0,45 s

• Tidak > ½ kali durasi interval R-R
 Gelombang U
• Bisa muncul dan paling
jelas pada V2 – V4
• Dihubungkan pada atlet
atau kondisi
hipokalemia dan
hiperkalsemia
 Menentukan Heart Rate
300 dibagi kotak besar antara R-R
1500 dibagi kotak kecil antara R-R
RHYTM DISTURBANCES
Sinus Bradikardi
 Sick Sinus Syndrome
• Dysfunction of the sinoatrial node,
impairment to generate & conduct impulses.
• EKG: persistent sinus bradycardia, periods of
sinoatrial block, sinus arrest, junctional or
ventricular escape rhythms, tachycardia-
bradycardia syndrome, paroxysmal atrial
flutter, & atrial fibrillation.
 AV Conduction Block
• Delayed (type I), intermittenly blocked (type
II), completely blocked (type III)
 First degree block
• A delay in conduction of the atrial impulse to
the ventricles, usually at the level of the
atrioventricular node.
• Prolongation of the PR interval to > 0.2 s.
• A QRS complex follows each P wave, and the
PR interval remains constant.
 Second degree block
• Mobitz Type I
Normal initial PR interval
but progressively lengthens
until eventually AV
transmission is blocked
completely, then the cycle
repeats.
• Mobitz Type II
Intermittent failure of
conduction of P waves. The
PR interval is constant,
though it may be normal or
prolonged.
 Third degree block
• Complete failure of conduction between the atria and
ventricles, with complete independence of atrial and
ventricular contractions.
• The P waves bear no relation to the QRS complexes and
usually proceed at a faster rate.
Bundle Branch Block
 Aritmia
Gangguan irama jantung berupa segala jenis
irama jantung selain IRAMA SINUS

Supraventrikular Ventrikular
QRS sempit seperti normal QRS lebar > 0,12 dt
(kecuali beberapa hal:
BBB, WPW,aberans)
 Aritmia Supraventrikular

Premature beat Takikardi aritmia

/ ekstra sistolik

Atrial Flutter Supra Ventrikel Takikardi/

Atrial fibrilasi Paroksismal Atrial Takikardi
150 - 250 x/mnt
•Sinus Ritme
•Sinus Aritmia
•Sinus Takikardi
•Sinus bradikardi
Atrial Fibrillation

•Irregular RR interval
•Frequency of P waves 350-
600 beats/min
Atrial Flutter

•Regular RR interval
•Frequency of P waves
about 300 beats/min
•Saw toothed appearance
best seen in the inferior
leads & V1
•Ventricular rate about 150
b/m
 Aritmia Ventrikular

Premature beat Takikardi aritmia

/ ekstra sistolik

Ventrikel Takikardi Ventrikel Fibrilasi

N N
100-250 x/mnt > 350 x/mnt
Ventricular Tachycardia
Torsades de Pointes
Ventricular
Fibrilation
CARDIAC AXIS
INFARCTION & ISCHEMIA
Acute Myocardial Infarction
Acute Myocardial Infarction
Acute Myocardial Infarction
Acute Myocardial Infarction
Myocardial Ischemia
Myocardial Ischemia
Myocardial Ischemia
ENLARGEMENT
Right Atrial Enlargement
Right Ventricular Hypertrophy
Left Atrial Abnormality
Left Ventricular Hypertrophy
CONDITIONS NOT PRIMARILY
AFFECTING THE HEART
Hyperkalemia
Hypokalaemia
Hypothermia
Thyrotoxicosis
Hypothyroidism
 Normokardi (Sinus rhytm)
Sinus Bradikardi
Takikardi
Ekstrasistol
atrial Atrial flutter,
Irama Supraventrikuler
Takikardi atrial fibrilasi
Aritmia aritmia Supraventrikular
Non Blok Ekstrasistol Takikardi
ventrikel
Aritmia Ventrikular
Takikardi Ventrikular Takikardi
Blok AV aritmia Ventrikular Fibrilasi
Blok
Bundle Branch Block
Normal
Frontal LAD
RAD
Sumbu
Normal
Horizontal CWR
CCWR
Normal
Kiri
Atrium
Besar Kanan
Kiri
Ventrikel
Kanan
Infark/ Negatif

Iskemia Positif
INTERPRETATION