TO START:……………………………..

CONCENTRATION, SPIRIT , and SMILE

RINGKASAN TOPIK INTERPRETASI EKG

EKG: rekaman aktivitas listrik jantung pada permukaan tubuh

Langkah Interpretasi:

• R hythm

• R ate

• A xis

• H ypertrophy

• I schemia

• I nfacrt

+ + + + + + + + + + + +

+ + + + + + + + + + + +

+ + + + + + + + + + + +

Resting

Depolarization

Repolarization

Transmembrane Potential

+ + + + + + + + + +

_ _ _ _ _ _ _ _ _ _ _ _

+

+

ELECTRICAL IMPLUSE ELECTRODE ECG

++++++++

_ _ _ _ __ _ _ _ _ _ _

Normal Conduction System

DEPOLARIZATION AND REPOLARIZATION OF ATRIUM AND VENTRICLE

Standard limb leads (Sandapan Ekstremitas)

Augmented Leads

Precordial Leads (Sandapan Dada)

Sandapan Dada Kanan

EKG: MEMOTRET JANTUNG DARI SISI FRONTAL DAN HORIZONTAL

AVF

III II

AVR

+

+

+

+

I

+ IRAMA SINUS

Sistem Konduksi Jantung

ECTOPIC FOCUS

Premature Atrial Contraction(Atrial Ekstrasistole)

Premature Atrial Contraction

Premature Junctional Contraction(Atrial Ekstrasistole)

Premature Junctional Contraction

Premature Junctional Contraction(Atrial Ekstrasistole)

Premature Ventricular Contraction (Ventricular Extrasystole)

ARRHYTHMIASARRHYTHMIAS

BRADYARRHYTHMIASBRADYARRHYTHMIAS TACHYARRHYTHMIASTACHYARRHYTHMIAS

FAILURE OF IMPULSE FORMATION (SINUS ARREST)

FAILURE OF PROPAGATION

(SA EXIT BLOCK, AV BLOCK, RBBB, LBBB)

AUTOMATICITY

TRIGGERED ACTIVITY

REENTRY

(AVNRT, AVRT, AT, AFlut)

GANGGUAN PEMBENTUKAN IMPULS DAN HANTARAN (BLOCK)

SINUS ARREST AND EXIT BLOCK

AV BLOK DERAJAT 1

AV BLOK DERAJAT TIPE I (Wenckebach)

AV BLOK DERAJAT TIPE II

AV DISSOSIASI

AV BLOK DERAJAT 3 (Complete Heart Block)

RIGHT BUNDLE BRANCH BLOCK

LEFT BUNDLE BRANCH BLOCK

Approach to Tachyarrhythmia

Narrow Complex TachyNarrow Complex Tachy

(NCT)(NCT)

Broad Complex TachyBroad Complex Tachy

(BCT)(BCT)

AV Nodal Reentrant Tachy

( AVNRT)

Atrio-Ventricular ReciprocatingTachy (AVRT)

Atrial Tachycardia

Atrial Flutter

Atrial Fibrillation

SVT with Aberrant SVT with Aberrant Conduction (BBB)Conduction (BBB)

Pre-excited TachycardiaPre-excited Tachycardia

Ventricular TachycardiaVentricular Tachycardia

SVT

Re-entry in AVNRT

AV Nodal Reentrant Tachycardia (AVNRT):

Narrow QRS Complex Tachycardia

Regular Irregular Irregular

Atrial Fibrillation

MultifocalAtrial

Tachycardia

Response to AV Block

Tachycardia Termination

with AV Block

Tachycardia Continues Despite

AV Block

Delta Wave

No Delta Wave

A Flutter AT S. Tachy

Approach to Narrow QRS Complex Tachycardia Approach to Narrow QRS Complex Tachycardia

• CAP• AVNRT• PJRT

• WPW

Re-entry

AVNRT AVRT Atrial Tachycardia

REENTRY IN VARIOUS SITES

Broad Complex Tachycardia

REGULARREGULAR IRREGULARIRREGULAR

SVT WITH BBBSVT WITH BBB

SVT OVER APSVT OVER AP

VTVT

AF WITH BBBAF WITH BBB

AF WITH AP AF WITH AP (PREEXCITED AF)(PREEXCITED AF)

TORSADES DE TORSADES DE POINTESPOINTES

VFVF

SVT

SVT

Typical (Counterclockwise) A Flutter

Atrial Fibrillasi (AF)

Ventricular Tachycardia

Torsades de Pointes

AXIS

0 Lead I

+90

Lead AVF

180

-90

2

1

34

56

Lead I Lead AVF

1

2

3

4

5

6

HIPERTROFI

L V H

R V H

ISKEMIA DAN INFARK

STEMIUNSTABLE ANGINA/NSTEMI

Langkah Interpretasi:

• R hythm

• R ate

• A xis

• H ypertrophy

• I schemia

• I nfacrt