ELEKTROKARDIOGRAFI

Departemen Kardiologi dan Kedokteran Vaskuler

Fakultas Kedokteran
Universitas Sumatera Utara
 R DEFINISI KONFIGURASI EKG

-------- = depolarisasi ventrikel

P T
U P

Q S

Gel. P = defleksi akibat depolarisasi atrium Gel. R’(r’) = defleksi negatif awal akibat
Gel. Q(q) = defleksi negatif awal akibat depolarisasi ventrikel yg mengi-
depolarisasi ventrikel yg kuti gel. (R)
mendahului gel. (R) Gel.T = defleksi akibat repolarisasi ventr.
Gel. R(r) = defleksi positif awal akibat Gel. U = defleksi (biasanya positif) sete-
depolarisasi ventrikel lah gel T dan mendahului gel P
Gel. S(s) = defleksi negatif awal akibat -------- = depolarisasi atrium
depolarisasi ventrikel yg mengikuti -------- = depolarisasi dan repolarisasi
gel. (R) ventrikel
The diagram illustrates ECG waves and intervals as well as standard time and voltage measures on the ECG paper.

Gelombang ECG dan INTERVAL: Apa arti dari gelombang EKG ?

 Gelombang P : sekuensial depolarisasi atrium kiri dan kanan
 Kompleks QRS complex: depolarisasi ventrikel kiri dan kanan
 Gelombang ST-T : repolarisasi ventrikel
 Gelombang U : sumber gelombang ini masih dalam perdebatan
 Interval PR interval: waktu mulai dari depolarisasi atrium (gelombang P) sampai permulaan depolarisasi
ventrikel (kompleks QRS)
 Durasi QRS duration: durasi depolarisasi otot ventrikel (lebar kompleks QRS)
 Interval QT: durasi depolarisasi dan repolarisasi ventrikel
 Interval PP : rate dari atrium atau sinus cycle
 Interval RR : rate dari ventricular cycle
 DEFINISI KONFIGURASI GELOMBANG EKG

Kertas EKG
Horizontal menyatakan kecepatan kertas
dalam waktu
1 mm = 0,04 detik
5 mm = 0,2 detik
Vertikal menyatakan voltage elektris jantung
dalam millivolt
10 mm = 1 mV
Pada pemeriksaan rutin kecepatan rekaman
kertas EKG 25 mm/detik

1 mm = 0,1 mV 1 mm = 0,04 detik

10 mm = 1 mV 5 mm = 0,2 detik
NILAI NORMAL :
Gelombang P : durasi : 0.08 – 0.10 / 0,12 detik
tinggi (voltase) : < 2,5 mm
Interval PR : 0,12 – 0,20 detik
Kompleks QRS : durasi : 0,06 – 0,10 detik
tinggi : > 5 mm standard limb lead ; > 10 mm chest lead
Interval QT : ♀ < 0,42 ; ♂ < 0,44 detik
Interval QTc : QT √ RR
Gelombang T : 1/8 – 2/3 dari tinggi gelombang R
Segmen ST : isoelektris
 DEPOLARISASI

- - + +
+ + - -

+ + - - Stimulasi sel otot

- - + +

- - + - - +

Defleksi atas Defleksi bawah

- +
Defleksi bifasik
SISTEM HANTARAN JANTUNG dan GELOMBANG EKG
SANDAPAN JANTUNG (LEAD)
Lead jantung ada 2 :
1. Bipolar standard lead (Einthoven) yaitu :I, II, III dan aVR, aVL, aVF
2. Unipolar lead (Wilson 1932) yaitu V1 sampai V9 dan V3R sampai 9R serta
3V1-9 sampai 3V3R-9R dan adalagi esofageal lead (E lead)
EKG rutin terdiri dari 12 lead yaitu : I,II,III; aVR, aVL, aVF dan V1-6 pada
dewasa serta pada anak yaitu : I,II,III; aVR, aVL, aVF dan V1-6 ditambah
V3R dan V4R

Standard Lead
CHEST LEAD Posisi chest lead dari belakang

Posisi chest lead dari depan

Ilustrasi posisi unipolar chest lead pada potongan transversal toraks
HEART RATE
Menentukan Heart Rate dari Electrocardiogram

Ada berbagai metode yang dapat digunakan untuk menghitung denyut jantung dari
EKG, dengan kecepatan kertas EKG25 mm/sec.
Salah satu metode adalah membagi 1500 dengan jumlah kotak kecil diantara
dua gelombang R (garis panah merah). Sebagai contah, rate diantara beat 1 dan
2 pada EKG diatas adalah 1500/22, yang sama dengan 68 denyut /min.
Alternatif lain,adalah dengan membagi 300 dengan jumlah kotak besar (garis
panah biru pada diagram), yaitu 300/4.4 (68 denyut /min).
Metode lain, adalah "count off" method. Dengan menghitung jumlah kotak besar
diantara gelombang R mengikuti rate: 300 - 150 - 100 - 75 - 60. Sebagai contoh jika
ada 3 kotak besar diantara gelombang R denyut jantung adalah 100 denyut/min.
MENGHITUNG DENYUT JANTUNG DARI EKG :
a. Irama Sinus : 1.1500 / jarak RR (kotak kecil)

2. 300 / jarak RR (kotak besar)

b. Sinus aritmia : 1. Hitung jumlah RR dalam 5 detik atau,
2. Hitung jumlah RR dalam 6 detik atau,
3. Hitung jumlah RR dalam 10 detik,
kemudian
1. HR = (jumlah RR dalam 5 detik x 12), atau
2. HR = (jumlah RR dalam 6 detik x 10 atau), atau
3. HR = (jumlah RR dalam 10 detik x 6)
0 5 6 10

HR = jumlah gel R x 60/5 atau jumlah gel R x 60/6

 “Count off" method

1 kotak besar = 300

2 kotak besar = 150
3 kotak besar = 100
4 kotak besar = 75
5 kotak besar = 60
6 kotak besar = 50
7 kotak besar = 43
8 kotak besar = 37

0 1 2 3 4 5 6 7 8
AKSIS JANTUNG
AKSIS JANTUNG

Stimulus depolarisasi dan repolarisasi didalam jantung menyebar ke

berbagai arah didalam jantung sesuai dengan posisi anatomi jantung
Aksis jantung : 1. Aksis QRS
2. Aksis gelombang P
3. Aksis gelombang T
1. Aksis QRS : arah depolarisasi gelombang QRS pada frontal plane
yang ditentukan oleh posisi anatomi jantung
2. Aksis P : arah depolarisasi gelombang P pada frontal plane
3. Aksis T : arah repolarisasi gelombang T pada frontal plane
Determining the Mean Electrical Axis (QRS axis)

Lead I : 4 – 0 = 4
Lead aVF : 12 – 2 = 10
 Lead I : 4 – 0 = 4
- = 270°
Lead aVF : 12 – 2 = 10

- = 180° I
+ = 0°/360°

aVF

+ = 90°
Determining the Mean Electrical Axis (QRS axis)

Axis nomenclature Lead I Lead aVF

1. Normal axis (0 to +90 degrees) Positive Positive
2. Left axis deviation (-30 to -90) Also check lead II. To
be true left axis deviation, it should also be down in
Positive Negative
lead II. If the QRS is upright in II, the axis is still
normal (0 to -30).
3. Right axis deviation (+90 to +180) Negative Positive
4. Indeterminate axis (-90 to -180) Negative Negative
ARTI KLINIS AKSIS QRS

Differential Diagnosis
LVH, left anterior fascicular block, inferior
wall MI, PVC from the right ventricle, WPW
Left axis deviation syndrome activating the right ventricle,
Pregnancy, Ascites, Abdominal tumor,
exhalation.
RVH, left posterior fascicular block, lateral
wall MI, PVC from the left ventricle, WPW
Right axis deviation
syndrome activating the left ventricle,
Emphysema, Inhalation
HIPERTROFI
Hipertrofi Jantung
Hipertrofi Jantung : 1. Atrium : a. Atrium kiri
b. Atrium kanan
c. Biatrial
2. Ventrikel : a. Ventrikel kiri
b. Ventrikel kanan
c. Biventrikel

1. Pembesaran atrium : (leads II and V1).

a. Hipertrofi atrium kiri - lead II : Notched wide (> 3mm) gelombang P.

- V1 : defleksi terminal negatif bertambah

b. Hipertrofi atrium kanan - lead II : Amplitudo gelombang P > 2.5mm.

- V1 : defleksi terminal negatif bertambah.

c. Biatrial : gabungan
Hipertrofi atrium : (leads II and V1).
P Pulmonal

P Mitral
Hipertrofi
atrium ka
nan
Biatrial
Hipertrofi
atrium kiri
2. Ventrikel : a. Ventrikel kiri

b. Ventrikel kanan

c. Biventrikel
a. Ventrikel kiri
•1. LVH: (Left ventricular hypertrophy).
a. Gelombang S (terbesar) di V1 atau V2
(dlm mm) ditambah gelombang R
(terbesar) di V5 atau V6 (dlm mm) >
35mm. ("voltage criteria“)
b. Gelombang R > 12 mm di aVL (LVH is
more likely with a "strain pattern"
which is asymmetric T wave inversion
in those leads showing LVH).

Summary :
• S wave V1 or V2 or R wave V5 or V6
of 30mm or greater.
• LAD
• QRS duration upper limit of normal
• Shift in the ST segment or T wave
(strain pattern) V5 and V6
b. Ventrikel kanan

•RVH: (Right ventricular hypertrophy).

Gelombang R > gelombang S di V1
dan Gelombang R menurun dari V1
sampai V6.

Summary of Criteria for RVH

Remember, again, that the electrocardiographic criteria for chamber enlarge-
ment have both low sensitivity and specificity. In summary, these are the
things to look for when trying to diagnose RVH:
1. R to S ratio of >1.0 in V1 or V2
2. RAD
3. Normal QRS duration
4. Strain pattern V1 or V2 and in limb leads with the tallest R wave
c. Biventrikel
Merupakan gabungan kriteria RVH dan LVH

ARTI KLINIS HIPERTROFI JANTUNG :

1. Pembesaran atrium kanan : ASD, PAPVR, Ebstein anomali
2. Pembesaran atrium kiri : Mitral stenosis, Mitral regurgitasi
3. Hipertrofi ventrikel kiri : Hipertensi, Aortic stenosis, Aortic regurgitasi,
Mitral regurgitasi, VSD, PDA
4. Hipertrofi ventrikel kanan : PPOK, ASD, Pulmonal stenosis
RAE LAE
RVH LVH
ISKEMIA & INFARK
Infarct , injury and ischaemic
 Normal

Progression of an Acute Myocardial

Infarction

An acute MI is a continuum that extends from

the normal state to a full infarction:
Ischemia

■ Ischemia—Lack of oxygen to the cardiac

tissue, represented by ST segment
depression, T wave inversion, or both
■ Injury—An arterial occlusion with ischemia,
represented by ST segment elevation
Injury
■ Infarction—Death of tissue, represented by a
pathological Q wave

Infarctio
n
a b

Hubungan antara lokasi

infark dan oklusi arteri
koroner (panah), dan lead
elektrocardiogram.
a. Anteroseptal infark.
b. Anterior infark
Extensive (anterolateral
infarction)
c. Infark lateral isolated
infarction
c
 d. Infark Inferior f. Right ventricular
“infarction” (combined
to inferior infarction)
d

e e. Infark Posterior f
Ishemia – Injury - Infarct

Accurate ECG interpretation in a patient with chest pain is critical. Basically,

there can be three types of problems - ischemia is a relative lack of blood
supply (not yet an infarct), injury is acute damage occurring right now,
and finally, infarct is an area of dead myocardium. It is important to realize
that certain leads represent certain areas of the left ventricle; by noting which
leads are involved, you can localize the process. The prognosis often varies
depending on which area of the left ventricle is involved (i.e. anterior wall
myocardial infarct generally has a worse prognosis than an inferior wall infarct).

V1-V2 anteroseptal wall

V3-V4 anterior wall
V5-V6 anterolateral wall
II, III, aVF inferior wall
I, aVL lateral wall
posterior wall
V1-V2
(reciprocal)
NON-TRANSMURAL = SUB ENDOCARDIAL = non Q-WAVE M.I.

depresion
TRANSMURAL = MYOCARDIAL = Q-WAVE M.I.

elevation
Figure.
a. Acute infarction: correlation between
the electrocardiogram (ECG) and the
stage of myocardial ischemia.
Monophasic ST deformation
/“transmural” lesion = lesion / injury.
b. Subacute infarction. Correlation
between the ECG and the stage of
myocardial ischemia (ST elevation =
lesion, plus pathologic Q wave =
necrosis, plus negative T wave =
ischemia).
c. Evolution of subacute infarction to
chronic infarction
Figure V3 lead: Evolution of QRS and ST/T morphologies in STEMI due to
occlusion of LAD.
(a) Few minutes; (b) 1 hour; (c) 1 day; (d) 1 week.
Figure 9.3. The evolution of an inferior
wall myocardial infarction, as seen in
lead III of a 55-year-old white male. Note
that the admission tracing shows only
ST elevation. A Q wave is beginning to
form by 1 hour, and ST elevation is on
the way down. By 24 hours, Q wave
formation is complete,
and the T wave is fully inverted. By 1
year, a pathologic Q wave is the only
remaining evidence of infarction.
Myocard infark :
1. Hyperacute T wave
2. ST segment changes T wave changes associated
3. Pathological Q wave with ischaemia
4. Resolution of changes of ST segment
and T wave
5. Reciprocal ST segment depression
The ECG shows:
• Sinus rhythm
• Normal axis
• Q waves in leads V2-V4
• Raised ST segments in leads V2-V4
• Inverted T waves in leads I, VL, V2-V6
The ECG shows:
• Sinus rhythm
• Normal axis
• Small Q waves in leads II, III, VF
• Biphasic T waves in leads II, V6; inverted Twaves in leads III, VF
• Markedly peaked T waves in leads V1-V2
ARITMIA
1. SINUS RHYTHM

Source: Male, 48 years old, Heart Rate: 65bpm, PR: 188ms, QRS: 92ms
Normal Sinus Rhythm
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - (60-100 bpm)
•All P waves are followed by QRS complex
•P Wave - Visible before each QRS complex
•P-R Interval - Normal (<5 small Squares. Anything above and this would be 1st
degree block)
•QRS Duration - Normal
•Indicates that the electrical signal is generated by the sinus node and travelling
in a normal fashion in the heart.
•Sinus Bradycardia
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - less than 60 beats per minute
•QRS Duration - Normal
•P Wave - Visible before each QRS complex
•P-R Interval - Normal
•Usually benign and often caused by patients on beta blockers & healthy
athletic person
•Sinus Tachycardia
An excessive heart rate above 100 beats per minute (BPM) which originates from the SA node.
Causes include stress, fright, illness and exercise. Not usually a surprise if it is triggered in
response to regulatory changes e.g. shock. But if their is no apparent trigger then medications
may be required to suppress the rhythm
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - More than 100 beats per minute
•QRS Duration - Normal
•P Wave - Visible before each QRS complex
•P-R Interval - Normal
•The impulse generating the heart beats are normal, but they are occurring at a faster pace than
normal. Seen during exercise
•Atrial Fibrillation 
Many sites within the atria are generating their own electrical
impulses, leading to irregular conduction of impulses to the
ventricles that generate the heartbeat. This irregular rhythm can be
felt when palpating a pulse. Looking at the ECG you'll see that:
•Rhythm - Irregularly irregular
•Rate - usually 100-160 beats per minute but slower if on
medication
•QRS Duration - Usually normal
•P Wave - Not distinguishable as the atria are firing off all over
•P-R Interval - Not measurable
•The atria fire electrical impulses in an irregular fashion causing
irregular heart rhythm

Note ectopic focus top right corner of atria.

•Atrial Flutter 
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - Around 110 beats per minute
•QRS Duration - Usually normal
•P Wave - Replaced with multiple F (flutter) waves, usually at a ratio of 2:1
(2F - 1QRS) but sometimes 3:1
•P Wave rate - 300 beats per minute
•P-R Interval - Not measurable
•As with SVT the abnormal tissue generating the rapid heart rate is also in
the atria, however, the atrioventricular node is not involved in this case.
•Supraventricular Tachycardia (SVT) Abnormal
A narrow complex tachycardia or atrial tachycardia which originates in the 'atria' but is not
under direct control from the SA node. SVT can occur in all age groups
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - 140-220 beats per minute
•QRS Duration - Usually normal
•P Wave - Often buried in preceding T wave
•P-R Interval - Depends on site of supraventricular pacemaker
•Impulses stimulating the heart are not being generated by the sinus node, but instead are
coming from a collection of tissue around and involving the atrioventricular (AV) node
•1st Degree AV Block
1st Degree AV block is caused by a conduction delay through the AV node but all
electrical signals reach the ventricles. This rarely causes any problems by itself
and often trained athletes can be seen to have it. The normal P-R interval is
between 0.12s to 0.20s in length, or 3-5 small squares on the ECG.
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - Normal
•QRS Duration - Normal
•P Wave - Ratio 1:1
•P Wave rate - Normal
•P-R Interval - Prolonged (>5 small squares)
•2nd Degree Block Type 1 (Wenckebach)
Another condition whereby a conduction block of some, but not all atrial beats
getting through to the ventricles. There is progressive lengthening of the PR
interval and then failure of conduction of an atrial beat, this is seen by a dropped
QRS complex.
Looking at the ECG you'll see that:
•Rhythm - Regularly irregular
•Rate - Normal or Slow
•QRS Duration - Normal
•P Wave - Ratio 1:1 for 2,3 or 4 cycles then 1:0.
•P Wave rate - Normal but faster than QRS rate
•P-R Interval - Progressive lengthening of P-R interval until a QRS complex is
dropped
•2nd Degree Block Type 2 
When electrical excitation sometimes fails to pass through the A-V node or bundle of His, this
intermittent occurance is said to be called second degree heart block. Electrical conduction
usually has a constant P-R interval, in the case of type 2 block atrial contractions are not regularly
followed by ventricular contraction. Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - Normal or Slow
•QRS Duration - Prolonged
•P Wave - Ratio 2:1, 3:1
•P Wave rate - Normal but faster than QRS rate
•P-R Interval - Normal or prolonged but constant
•3rd Degree Block
3rd degree block or complete heart block occurs when atrial contractions are 'normal' but no
electrical conduction is conveyed to the ventricles. The ventricles then generate their own
signal through an 'escape mechanism' from a focus somewhere within the ventricle. The
ventricular escape beats are usually 'slow'
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - Slow
•QRS Duration - Prolonged
•P Wave - Unrelated
•P Wave rate - Normal but faster than QRS rate
•P-R Interval - Variation
•Complete AV block. No atrial impulses pass through the atrioventricular node and the
ventricles generate their own rhythm
•Junctional Rhythms
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - 40-60 Beats per minute
•QRS Duration - Normal
•P Wave - Ratio 1:1 if visible. Inverted in lead II
•P Wave rate - Same as QRS rate
•P-R Interval - Variable
Below - Accelerated Junctional Rhythm
Accelerated Junctional Rhythm
Regular Rhythm
•Heart Rate: 60 to 100 beats per minute (BPM)
•P Wave: Inverted, absent or after QRS
•PR Interval: Less then 120ms
•QRS Interval: Less then 120ms
•Asystole - Abnormal
Looking at the ECG you'll see that:
•Rhythm - Flat
•Rate - 0 Beats per minute
•QRS Duration - None
•P Wave - None
•Carry out CPR!!
Sinus Pause
Irregular Rhythm
Heart Rate: Undetermined
P Wave: Before each QRS, identical, dropped beat, p to p is undisturbed
PR Interval: 120 to 200ms
QRS Interval: Less then 120ms
Sinus Arrest
Irregular Rhythm
Heart Rate: Undetermined
P Wave: Before each QRS, identical, dropped beat, p to p is undisturbed
PR Interval: 120 to 200ms
QRS Interval: Less then 120ms

heartrhythmguide.com, © 2008
Premature Atrial Contraction Isolated
Irregular Rhythm
•Heart Rate: None
•P Wave: Premature and abnormal or hidden
•PR Interval: Less then 200ms
•QRS Interval: Less then 120ms
Premature Atrial Contraction Paired
Irregular Rhythm
•Heart Rate: None
•P Wave: Premature and abnormal or hidden
•PR Interval: Less then 200ms
•QRS Interval: Less then 120ms
Premature Atrial Contraction Atrial Bigeminy
Irregular Rhythm
Heart Rate: None
•P Wave: Premature and abnormal or hidden
•PR Interval: Less then 200ms
•QRS Interval: Less then 120ms
Wandering Pacemaker
Irregular Rhythm
•Heart Rate: Less then 60 beats per minute (BPM)
•P Wave: Multiple forms
•PR Interval: Variable
•QRS Interval: Less then 120ms
Ventricle Extra Systole =
Ventricle Premature Contraction
•Premature Ventricular Complexes
 Due to a part of the heart depolarizing earlier than it should. Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - Normal
•QRS Duration - Normal
•P Wave - Ratio 1:1
•P Wave rate - Normal and same as QRS rate
•P-R Interval - Normal
•Also you'll see 2 odd waveforms, these are the ventricles depolarising prematurely in response to a signal within
the ventricles.(Above - unifocal PVC's as they look alike if they differed in appearance they would be called
multifocal PVC's, as below)
•Ventricular Tachycardia (VT) Abnormal
Looking at the ECG you'll see that:
•Rhythm - Regular
•Rate - 180-190 Beats per minute
•QRS Duration - Prolonged
•P Wave - Not seen
•Results from abnormal tissues in the ventricles generating a rapid and irregular
heart rhythm. Poor cardiac output is usually associated with this rhythm thus
causing the pt to go into cardiac arrest. Shock this rhythm if the patient is
unconscious and without a pulse
•Ventricular Fibrillation (VF) Abnormal
Disorganised electrical signals cause the ventricles to quiver instead of contract in
a rhythmic fashion. A patient will be unconscious as blood is not pumped to the
brain. Immediate treatment by defibrillation is indicated. This condition may occur
during or after a myocardial infarct.
Looking at the ECG you'll see that:
•Rhythm - Irregular
•Rate - 300+, disorganised
•QRS Duration - Not recognisable
•P Wave - Not seen
•This patient needs to be defibrillated!! QUICKLY
 The
Deadly
Rhythms

PEA
VT VF (Pulse less
Electrical
Activity)
Asystole
Wolff-Parkinson-White syndrome
Diagnostic criteria for right bundle branch block
1. QRS duration >0.12 s
RIGHT BUNDLE
2. A secondary R wave (R’) in V1 or V2 BRANCH BLOCK (RBBB)
3. Wide slurred S wave in leads I, V5, and V6
Associated feature
1. ST segment depression and T wave inversion
in the right precordial leads
 LEFT BUNDLE
BRANCH BLOCK
(LBBB)

Diagnostic criteria for left bundle branch block

1. QRS duration of >0.12 s
2. Broad monophasic R wave in leads 1, V5, and V6
3. Absence of Q waves in leads V5 and V6
Associated features
1. Displacement of ST segment and T wave in an opposite direction to the
dominant deflection of the QRS complex (appropriatediscordance)
2. Poor R wave progression in the chest leads
3. RS complex, rather than monophasic complex, in leads V5 and V6
4. Left axis deviation—common but not invariable finding
KRITERIA LAH :
1. LAD, sering mendekati −60 derajat
2. Gelombang R kecil di lead III
3. Gelombang Q kecil di lead I
4. Normal QRS durasi

LEFT ANTERIOR
HEMIBLOCKS
KRITERIA LPH :
1. RAD, sering mendekati +120 derajat
2. Gelombang Q kecil di lead III
3. Gelombang R kecil di lead I
4. Normal QRS durasi

LEFT POSTERIOR
HEMIBLOCKS
TERIMA KASIH
INTRAVENTRICULAR
CONDUCTION DELAY

1. RIGHT BUNDLE BRANCH BLOCK (RBBB)

2. LEFT BUNDLE BRANCH BLOCK (LBBB)
3. LEFT ANTERIOR HEMI BLOCK (LAH)
4. LEFT POSTERIOR HEMI BLOCK (LPH)
BUNDLE BRANCH BLOCK :
1. KOMPLIT : - kanan : RIGHT BUNDLE BRANCH BLOCK
(>0,12”) - kiri : LEFT BUNDLE BRANCH BLOCK
2. INKOMPLIT : - kanan : INCOMPLETE RIGHT BUNDLE BRANCH BLOCK
(<0,12”) - kiri : INCOMPLETE LEFT BUNDLE BRANCH BLOCK
Dextroposisi dan Dextrocardia

Normal
Dextroversi / Dextroposisi
Dextrocardia
Cara membedakan normal/dextroposisi dengan dextrocardia

Normal Dextrocardia
LA-RA I -I
LL-RA II III
LL-LA III II
aVR aVL
aVL aVR
aVF aVF
 Normal Dextrocardia
LA-RA I -I
LL-RA II III
LL-LA III II
aVR aVL
aVL aVR
aVF aVF