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FORMAT INTERPRESTASI EKG 12 LEAD

KELOMPOK

: _______________________

ANGGOTA

PERIODE

: _______________________

1. ___________________________________
2. ___________________________________
3. ___________________________________

Nama Pasien

: ____________________________________________________________

Tanggal Perekaman

: ____________________________________________________________

Ritme

: Reguler/irreguler

Frekuensi

: __________ kali/menit

Irama

: ____________________________________________________________

Zona Transisi

: ____________________________________________________________

Aksis Jantung

: ____________________________________________________________

Morfologi Gelombang (Gelombang P, Q, R, S, T, U, Kompleks QRS, dll) :


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Kelainan Jantung

: ____________________________________________________________