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A. S I S T E M KONDUKSI
J A NT U NG

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 SIKLUS JANTUNG

Proses Perambatan
Arus S I K L U S
JANTUNG:
  NSA
kontraksi Atrium
(
G
K ontraks i
el
B E R K A S IS (Ka!K") . ventrikel
P
) ( Kompleks 3
Serabut Pur#"n e QRS)
L a n ju ta n ....

4
B . L I S T R I K DAN J A N T U N G
• J a n t u n g t . d 3 jen! !e"#
1. S e " $a%e&a'e(  # n ) d u !
SA
*e&+ang't
2 . S e " ' ) n d u ' !  "!t(' ' a +e "
3 . S e " &)'a(du& &e!n
')nt(a't"
• A't,ta! "!t(' ! e " jantung#
1. De*)"a(!a!# ' ) n t ( a ' ! 
E K G
2. Re*)"a(!a!# !t(a-at

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 / .E L E K T R OK A R DIOG R A M
(EKG)
• E"e't()'a(d)g(a0 # "&u ang & e &* e " a ja (

• a't,ta! "!t(' j a n t u n g
E " e ' t ( ) ' a ( d  ) g ( a & EKG# g(a0' ang
& e n g g a & + a ( ' a n ( e ' a & a n "!t(' j a n t u n g
• Ge")&+angge")&+ang d a " a & E K G t&+u"
a'+at de*)"a(!a! d a n (e*)"a(!a! &  ) ' a ( d

d(e'a& d a " a & ' e ( t a ! E K G


E K G d a n Ke"!t('an J a n t u n g #


E. SADA$AN E K G

1. S a d a * a n E ' ! t ( e &  t a ! # &e"-at

da( 7 R O N T A L ata!
+ a 8 a - a t a u ' a n a n  '(
a. S a d a * a n ! t a n d a ( # I9 II9 I I I
+. S a d a * a n ta&+a-an# a : R 9
a:L9 a : 7
a: R
a: L

6
III
a: 7
S a d a * a n $(e')(da"<
2 . S a d a * a n $(e')(da" dada#
&e"-at j a n t u n g ! e % a ( a

=ORISONTAL>TRANS:ERSAL
 ante()(9 * ) ! t e (  ) ( 9 " a t e ( a "
 T.d# : 1 9 : 2 9 : 3 9 : 4 9 : 5 9 :

;
Sada*an "anjut<

1?
Sada*an "anjutan<

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S A DA $ A N

• In0e()(# II9 III9 a : 7

• L a t e ( a " '(# I9 a : L 9 : 5 9 :
• Ante()(# : 1 9 : 2 9 : 3 9 : 4
 :19 :2# ante()!e*ta"

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KERTAS GRAFIK EKG

VOLTAGE

WA K T U

Penukuran!
Kotak " o rison tal : % mm & '.' et"#
  % #ota# besar ( *
mm)
Kotak Vertikal: % mm&' . +
&''.%
et"#mV
  % #ota# besar: 13
D. G R A F I K E K G
Gra-"# E K G normal ter"r" ar" ua #omonen,
/a"tu berua:
%. Gelomban0: P, 1 R S , T
+. Gar"s lurus: se0men S T , "nter2al P R ,
"nter2al 1 T

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I n t e ( * ( e t a !  =a!"
• 7(e'uen!
• I(a&a
• G e " ) & + a n g # Du(a! d a n B e n t u '
• A@!

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#$ R A T E
4o rmal &eart rate ! 6 , 2 # , , 1*minutes
3 9 # , , 1*minutes ! S i n u s Ta5&85ar'ia
3 : 6 , 1*minutes ! S i n u s ; r a ' i 5 a r ' i a

%etermination &eart rate (normal paper s p e e '  mm*s)!

3 +,,
- o u n t n u m . e r o/ lare s 0 u a r e ( . o l ' . o 1 e s in one R 2 R3 interval)

3 #,,
- o u n t n u m . e r o/ small s 0 u ar e in one R 2 R3 intervals
3 4 u m . e r o/ Q R S 5omple1 in 6 s e 5 o n ' s 7 multipl8 . 8 # ,
$
R"<T"=
4ormal 5 a r ' i a 5 r&8t&m ! S@4US r&8t&m

S i n u s r&8t&m 5&ara5teristi5s !
3 Rate 6 , > # , , . p m
3 - o n s t a n t R 2 R interval
3 4eative P ? a v e in a V R a n ' positive ' i @ @
3 P ? a v e i s a l ? a 8 s / o l l o ? e ' . 8 Q R S 5omple1
GELOMBANG $

• R e * ( e ! e n t a !  de*)"a(!a!
at(u& ' a n a n d a n '(
• Du(a!# ? 9 ? 4  ?911 !
• A&*"tud)#  3 & &   ?93
& ,>? 925 &:

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• Gelombang P (p wave) merupakan

gdarle om
i atbiraunmg kyanagn m dearne
pkrierisentatifkan kondisi
 pada sadapan
•• Informasi II
adanya dan
gangguan dapat di lihat
Pembesaran
V1 atrium kanan : amplitudo
 !"# mm pada sadapan II dan
kemungkinan
deviasi a$is gelombang P ke kanan
• Pembesaran %trium kiri : durasi meningkat
dan lebar bagian akhir (negatof) gelombang
P harus setidaknya sebesar 1 kotak  1;
 Atr"al /ertro4/
KOM$LEKS CRS
• M e ( u * a ' a n (e*(e!enta!
') nt ( a ' ! >de *) " a (!a !
,
• Du(a!# ?9??912 !
e n t ( ' e "
• K ) & * " e ' ! C R S te(d( da(#
1. G e " ) & + a n g C
2. G e " ) & + a n g R
3. G e " ) & + a n g S
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Ge")&+ang C
• M e ( e ' a & *e(!t8a de*)"a(!a! d
! e * t u & nt(a,ent('u"a(e
• M e ( u * a ' a n de0"e'! * e ( t a & a ' e
+ a 8 a - de0"e'! negat0 ! e t e " a -
ge")&+ang $
• De0"e'! ' e + a 8 a - -ana d a * a t
d!e+ut g e " ) & + a n g C +"a g"+ t ! +
& e ( u * a ' a n g e " ) & + a n g * e ( t a & a da(
')&*"e'! CRS
• Seta* de0"e'! ' e + a 8 a - ang "an d!
e+ut g e " ) & + a n g S
• A&*"tud)#  1>3 R 22
Ge")&+ang R
• M e ( u * a ' a n g e " ) & + a n g de0"e'!
' e a t a ! de0"e'!   *e(ta&a
!ete"a- ge")&+ang $
• De0"e'! ' e a t a ! ' e d u a ! e t e " a -
g e " ) & + a n g R d!e+ut R 
• A&*"tud)# 51? & &
• R tngg# -*e(t()0 : e n t (  ' e "

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Ge")&+ang S

• M e ( u * a ' a n ge")&+ang dengan

daen"0ge '&!en'ge '+uat8 ad-e 0*"ee'(t!a

&'ea 9 a t a !.

• De0"e'! ' e + a 8 a - ! e t e " a -

ge")&+ang R

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K)&*"e'! CRS
• & a m p u menentukan adanya 'IP*+PI
V,*I-. dengan sadapan
ekstermitas dan prekordial
• 'ipertropi venrikel kanan
(kongenital) :
1/ kstermitas : a$is ke kanan (lihat I
dan % V 0 )
!/ Prekordial : V 1    2 dan V 3
 2 4  'ipertropi Ventrikel -iri :
1/ Prekordial : %mplitudo  pd sadapan
V3 di5umlah amplitudo 2 pd sadapan
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Ge")&+ang T

• M e ( u * a ' a n (e*(e!enta!

• (e*)"a(!a! : e n t (  ' e "

De0"e'! ' e a t a !  
• A&*"tud)#
 5 &&# " e a d > ! a d a * a n ! t a n d a (  
 1 ? &&# ! a d a * a n
*(e')(da"
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Ga(! ga(! L u ( u !
1 . S e g & e n # ga(! " u ( u ! & e n g - u + . 2
ge")&+ang Seg&en ST
2 . I n t e ( , a " # &n. ! a t u g e ". dta&+a-

1n gtea((,!a "" uC(Tu! I n t e ( , a " $R9

3?
G E L O M B A N G R DAN S DI L E A D
PERIKORDIAL

  V#  V V+ V  V V6
   
Seg&en ST
• m e r u p a k a n repreen!a" # a k ! u a k $ " r
%ep&'ar"a" en!r"ke' ampa" a # a '
rep&'ar"a" en!r"ke'
• %"ukur %ar" a k $ " r e'&m*an S k e
a#a'
e'.T
• B e n t u ' n ) ( & a " # tda' &enga"a&
de*(e! F ?95 & & d a n e"e,a!  1
&&.
• S T e"e,a!# ')nd! a ' u t a t a u nju(
&)'a(d
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Segmen S T  
Diukur dari akhir QRS s/d aal gel !  

Normal : Isoelektris

Kepentingan
EDlepvra Pada insjkuermi/iianfark
 :
akut
esi i 

N5N S T 6 I S T6 I
I n t e ( , a " $R>P+ "n!era'

• M e ( u * a ' a n (e*(e!enta! 8 a ' t u

* e ( j a " a n a n &*u"!e da( S A n ) d e
& e n u j u at(u& d a n A : n ) d e ' e
,ent('e".
• $ R nte(,a" du'u( da(
a8a">na'na g e " ) & + a n g $
!a&*a a 8 a " ' ) & * " e ' !
CRS.
• Du(a! n ) ( & a " # ? . 1 2  ? . 2 34
Inte(,a" C T

• I n t e ( , a " C T &engnd'a!'an

8e, an'tt(u' (ee".*)"a(!a! at(u& d a n

• Du(a!#   nte(,a" R  R

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 IRAMA SINUS
2SINUS
R=HTM3 
K(te(a#
• I ( a & a Regu"e(

•• = R ?  1 ? ? @> &n
G e " ) & + a n g $ &enda-u"u !eta*
')&*"e'! CRS
• G e " ) & + a n g $ C R S T t&+u"
+e(u"ang
• B e n t u '  u ' u ( a n ge")&+ang
$CRST
!e!ua d g n ! t a n d a ( t
• I n t e ( , a " $R# n ) ( & a " ?912  ? 9 2 ? 
!
•
I ( a & a !nu!

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A R I T M I A HANG
MENGAN/AM
1. : E N T R I K E L 7IBRILASI

2. : E N T R I K E L T R A / I K A R D I
T A N $ A NADI
3. $ U L S L E S E L E K T R I / A / T I : I T E
 $EA 
4. A S I S T O L
7+("a! : e n t (  ' e "
•
:7
IFrraem
k #a e n  " - R
%"$"!un
,
%k
T" /%0a1k 2! e3mrae!nu"r!  $ !
%p!
• Ge'. P , T" % ak a %a
• In!era' P R , T " % a k a %a
• Ge'. + R S , L e * a r %an !"%ak ! e r a ! u r  
•   4 5 F kaar (6&are 5 F )
•   4 5 F $a'u ( F " n e 5 F )
Ta''a(d : e n t (  ' e "
T:
• Irama , Tera!ur  
• Frek#en" - R , 7 1 1 8 9 0 1 23men"!
• Ge'. P , T " %a k a %a
• In!era' P R , T " % a k a%a
• Ge'. + R S , L e * a r ' e * " $ %ar" 1 : 7 9 %e ! "k
$EA

$ A D A G A M B A R A N DI MONITOR

TAEKRTLI:I=ITAATS A LDIASNTRHIAK G

JAAMNBTAURNAGNT E T A $ I $ A D A
S A A T DI $ A L $ A S I

DENHUT NADI T I D A K T E R A B A
A S IS T OL

$ADA GAMBARAN MONITOR

TAIKDTAIK7I TAE S RELKISATMR IGKA

JMABNATRUANNGD A N N A D I
TIDAK TERABA
Ra J a n t u n g

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/ T R /a(d) T-)(a%% Rat)

• M e t ) d e ang d*a'a u n t u '

& e n e n t u ' a n adana

*%ea&d( +e)!&ae(agna "ja n t u n g

• R u & u ! # AB>/
• D  ' a t a ' a n %a(d)&ega" j'a
-a!" / T R  7"#
• Te(&a ' a !  -