Normal pacemaker of
the heart
0.12-0.20 sec
. . . . Normal ECG
Quality check
Kecepatan rekaman (25mm/s, 50 mm/s)
Standardisasi ( 1 cm/mV)
Gelombang P (+) di lead I,II
Gelombang P (-) di lead aVR
R wave progression (upright di V4)
Lead I + III = II
aVR + aVL + aVF = 0
How to read an ECG recording
1. Determine the rhythm: SR,ST,SB,AF,…
2. QRS rate : 60 – 100 bpm
3. QRS axis : 0 - +90˚
4. P wave morphology : P mitral, P Pulmonal
5. P axis
6. PR interval : 0.12 – 0.20 sec
7. QRS duration: 0.04 – 0.11 sec
8. ST – T segment changes
Apa yang harus dinilai ?
Rate
Rhythm
Axis
P wave
PR Interval
QRS duration
QRS pattern
Apa yang harus dinilai ?
ST Segment: isoelectric throughout.
QT Interval
QTc Interval
T wave
Extra: - aVR complexes are negative so no
evidence of limb lead misplacement
300
Count number of large square (bold boxes in one R – R’ interval)
1500
Count number of small square in one R – R’ intervals
Extreme
RAD LAD
RAD Normal
IV. Any hypertrophic signs ??
Atrial hypertrophy/enlargement?
II V1
. . . Any hypertrophic signs?
Ventricular hypertrophy?
Left Ventricular Hypertrophy
Sokolow and Lyon