JP, FIHA
PENANGANAN PENCEGAHAN
Pendahuluan : Tatalaksana
- anatomi Komplikasi
- sistem konduksi
- definisi
- klasifikasi
- mekanisme
- diagnosis
- penyebab
ARITMIA
MAU
TAHU
SANTAI
AJA
KALEEE
ANATOMI
Sistem Konduksi Jantung
‘0p
Irama Sinus Normal
Normal Cardiac Rhythm/ Normal Sinus Rhythm (NSR)
Definisi :
Aritmia Jantung (Cardiac
arrhythmia) adalah abnormalitas
dari irama jantung
KLASIFIKASI ARITMIA
Sinus node diseases
•Sinus tachycardia/ bradicardia
•SA block
•Wandering pace-maker
•Hypersensitive carotid sinus syndrome
•Sick – sinus – syndrome (sss)
Pre-excitation syndrome
•Wolff – Parkinson – white syndrome (δ – wave)
•LGL syndrome
•Mahaim syndrome
Heart block
•SA block
•1st degree HB
•2nd degree HB
•Wenckebach (mobitz type I)
•(mobitz type II)
•3rd degree HB (total AV block)
•Temporary pace-maker
•Permanent pace-maker
MEKANISME ARITMIA
Enhanced automaticity
• Sinus Tachycardia
Triggered automaticity
• Multifocal atrial tachycardia
• VES → VT Torsade de Pointes
Reentry
• Atrial Fibrilation (AF)
• Atrial flutter
• SVT
• VT
Block
• 1st degree AV block
• 2nd degree AV block
• 3rd degree AV block (total AV block)
Enhanced automaticity
Triggered automaticity
Reentry
JALAN RUSAK
BLOCK
CARA
DIAGNOSIS
70 %
Tolong Bu Dokter
Saya lagi sakit
DADA
To…too…tooloool
Eh… Tolong Dok
Eh..eh…aduuh
SAAKIIT
Gejala & Tanda Aritmia
Myocarditis
Endocrine
•Thyrotoxicosis
Electrolyte imbalance
Drug – induce
•Sympathomimetic, caffeine
Increased threshold
• Na+ channel blocker
• Ca++ channel blocker
Anti adrenergic
• β blocker
Autonomic Effects
• Vagus stimulation
• Digoxin
• Adenosine receptor activation
• Adenosine
Farmakokinetik
O P Dosis Kadar Metab Eks Indikasi Efek samping
puncak
KINIDIN + + 3 X 200 mg 60 – 90’ H G/H AF, SVT
PROKAINAMID + + 3X (250000 – 45 – 70’ H G VES, SVT Lupus like syndrome,
500) mg leukopeni
Hipotensi / Sinkop
Kardiovaskular
•SA block
•QRS – Interval •AV block
•Long QT •Torsades de Poentes
• ↑ ventrikuler rate (efek
anti kolinergik)
Cinchonism
•Demam
•Tinitus
•Penglihatn kabur
•Diplopia
•Sakit kepala
•Delirium
•Prikosis
•Gangguan GIT
Amiodaron
Farmakokinetik indikasi Efek samping
Sotalol
Farmakokinetik indikasi Efek samping
Heart Block
1. Atropine (I.V.)
2. Temporary Pacemaker
3. Permanent Pacemaker
Permanent Pacemaker
KOMPLIKASI
• Hipotensi
• Penurunan kesadaran
• Tanda-tanda syok lainnya
• Nyeri dada iskemik
• Gagal jantung akut
• Tromboemboli
• Aritmia maligna
• Kematian