FUNDAMENTAL ECG

Proposal IPAL Bayu Budi Laksono

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 WHY…??

Proposal IPAL
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 Sub title
• Anatomi dan fisiologi jantung
• Fundamental elektrofisiologi
• Fundamental Elektrokardiografi

Proposal IPAL •
•
•
•
Definisi dan Manfaat
Elektroda dan kertas EKG
Gelombang EKG
Vektor jantung / AXIS
• Menginterpretasikan EKG
• Arrhythmia/Dysrtyhmia

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 Anatomi dan fisiologi jantung

1. Automaticity
2. Iritability
3. Conductifity

Proposal IPAL
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Proposal IPAL
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 Fundamental elektrofisiologi
Bagaimana jantung menghasilkan impuls aksi potensial

Proposal IPAL
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 E

Proposal IPAL E

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 Fundamental Elektrokardiografi
Rekaman dari aktifitas elektrikal jantung pada selembatr kertas
Elektroda menangkap gelombang listrik jantung dan
mengirimkannya pada monitor/perekam yang ditampilkan dalam
bentuk rangkaian gelombang tertentu.

Proposal IPAL
• Mengetahui adanya aritmia/disritmia
• Mengidentifikasi adanya ACS/SKA
• Mengidentifikasi efek obat jantung
• Mengetahui ketidak seimbangan elektrolit

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Proposal IPAL
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 ECG LEADS
• Bipolar

Proposal IPAL
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 • Unipolar ekstrimitas

Proposal IPAL
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 • Unipolar Precordial

Proposal IPAL
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Proposal IPAL
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 Hexasial system / AXIS

Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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 Gelombang EKG
• P
• QRS complex
• T

Proposal IPAL • PR segment

• PR Interval
• ST Segment
• QT Interval
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 Menginterpretasikan EKG
• Hitung Hearth rate
• Mengukur regularitas gel R - R
• Memeriksa gel P

Proposal IPAL
•
•
Mengukur PR Interval
Mengukur QRS kompleks

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 Hitung Hearth rate

Proposal IPAL
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 Regularitas

Proposal IPAL
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 Memeriksa gel P

Proposal IPAL
Penting untuk mengidentifikasi asal impuls
• Maks 2,5 mv, 0,12 sec
• Positif d LII, Negatif d AVF
• 60 sd 100 bpm
 SA node  Sinus rhytm

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 PR interval

• < 0,2 sec (5 KK)

Proposal IPAL
• PR memanjang  AV block

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 QRS kompleks

Proposal IPAL
•
•
•
< 0,12 sec (3 KK)
15 sd 25 (v5 v6) mv
Q< 1/3 R
• R – S progresif di V1 sd V6
• S harus ada d V6 meskipun kecil

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Proposal IPAL
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 Arrhythmia/Dysrtyhmia
Menurut Asalnya
• SA
• Atrium

Proposal IPAL
• AV
• Ventrikel

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 SA
• Sinus
brady

Proposal IPAL • Sinus

Tachy

• Sinus
Aritmia

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 • SA Block

Proposal IPAL • Sinus

Arrest

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 Atrium
• Atrial
Tachy

Proposal IPAL • Atrial

Flutter

• A-Fib

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 • Multifical
Atrial Tachy

Proposal IPAL • WAP

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 AV
• Juctional
Rhytm

Proposal IPAL • Accelerated

Rhytm

• Junctional
tachy

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 Ventricle
• Idioventricu
llar

Proposal IPAL • Accelerated

• VT (mono
morfic)

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 • VT (Poly
morfic)

Proposal IPAL • Torsa de

pointes

• VF

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 • PEA

Proposal IPAL
• Asystole

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 Ekstra Systole
Menurut letaknya
• Atrial Extra Systole (AES/PAC)
• Juctional Extra Systole (JES/PJC)

Proposal IPAL
• Ventricular Extra Systole (VES/PVC)

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Proposal IPAL
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 Letal VES/PVC
• > 6x per menit
• Multivocal VES/PCV
• VES Consecutive / couplet

Proposal IPAL
•
•
VES R on T
VES selang seling
• Bigemini
• Trigemini
• Quatrigemini

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 BLOCK
• 1st degree

Proposal IPAL • 2nd degree

type I
(mobits I)

• 2nd degree
type II
(mobits II)
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 • 3rd degree

Proposal IPAL
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 ACS
• STEMI
• NSTEMI
• Unstable Angina

Proposal IPAL
• Stable Angina

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 ST Segment and T wave

Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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Proposal IPAL
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 AXIS
• Metode LI dan AVF (tegak lurus)
• R – S  L1 sumbu X, AVF sumbu Y
L1 L2 AVF Interpretasi

Proposal IPAL +

+
+

-
+

-
Normal

Normal

LAD

_ + + Normal

_ _ + RAD

_ _ ekstreme

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 • Metode Bifasik
1. Tentukan letak QRS terkecil
2. Cari pasangan tegak lurusnya
L1 Tegak lurus AVF
L2 Tegak lurus AVL
L3 Tegak lurus AVR

Proposal IPAL
3. R – S  tentukan +/-  Interpretasi Hexasial

• Metode high voltage

1. Tentukan letak QRS terbesar
2. R – S  tentukan +/-  Interpretasi Hexasial

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Proposal IPAL
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