Konsep Dasar Elektrokardiografi

Conduction System

SA Node
 Internodal branch
 AV Node
 Hiss Bundle
 Purkinje Fiber
 Contraction
 Sternomanubrial joint - Angle of Louis

V1 V2 V3 V4 V5 V6
3/29/2019 © Dr Paul Bradley, Clinical Skills Resource Centre, University of Liverpool, UK 4
 R

P T

Q
S
AXIS
 Right Axis Deviation Left Axis Deviation

LAD

RAD
 GELOMBANG P
Gambaran yang ditimbulkan oleh depolarisasi atrium

Normal
Tinggi : < 0,3 mvolt
Lebar : < 0,12 detik
Selalu positif di L II
Selalu negatif di aVR

Kepentingan
Mengetahui kelainan di Atrium
“Gelombang P Mitral”

“ Gelombang P Pulmonal “
P Pulmonale
P Mitrale
PR Interval
 Interval PR
Diukur dari permulaan P s/d permulaan QRS

Normal : 0,12 - 0,20 detik

QRS Complex
 GELOMBANG QRS

Gambaran yang ditimbulkan oleh depolarisasi ventrikel

Normal :
Lebar : 0,06 - 0,12 detik
Tinggi : Tergantung lead

Normal gelombang Q
Lebar : < 0,04 detik
Dalam : < 1/3 tinggi R
ST Segment
T Wave
24
2. RHYTHM

Normal cardiac rhythm : SINUS rhythm

Sinus rhythm characteristics :

• Rate 60-100 bpm
• Constant R – R interval
• Negative P wave in aVR and positive di II
• P wave is always followed by QRS complex
© Dr Paul Bradley, Clinical Skills Resource Centre, University of Liverpool, UK 3/29/2019 33
 ECG paper timings
Paper speed = 25
mm/second

RR interval

Rate = 300/RR interval (in large squares) or

= 1500/RR interval (in small squares)

Each small square Five small squares =

= 0.04 seconds 0.2 seconds Five large squares
(= 1/25 sec) (= 1/5 sec) = 1 sec

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37
3. AXIS
LVH
LVH
LVH
RVH
RVH
RVH
RVH
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