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Elektrokardiografi: Prof. Dr. Peter Kabo

The document discusses electrocardiography (EKG/ECG) patterns and rhythms, including: - Normal sinus rhythm and abnormalities like atrial fibrillation, supraventricular tachycardia, multifocal atrial tachycardia, premature ventricular contractions, ventricular tachycardia, first-, second-, and third-degree atrioventricular block. - Causes of various arrhythmias related to conditions like valvular heart disease, electrolyte imbalances, hypertension, hypoxia, and mechanical factors during or after cardiac surgery and cardiopulmonary bypass. - Measurement of intervals on EKG like PR, QRS, QT and clinical significance.

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Rey Alwiwikh
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96 views

Elektrokardiografi: Prof. Dr. Peter Kabo

The document discusses electrocardiography (EKG/ECG) patterns and rhythms, including: - Normal sinus rhythm and abnormalities like atrial fibrillation, supraventricular tachycardia, multifocal atrial tachycardia, premature ventricular contractions, ventricular tachycardia, first-, second-, and third-degree atrioventricular block. - Causes of various arrhythmias related to conditions like valvular heart disease, electrolyte imbalances, hypertension, hypoxia, and mechanical factors during or after cardiac surgery and cardiopulmonary bypass. - Measurement of intervals on EKG like PR, QRS, QT and clinical significance.

Uploaded by

Rey Alwiwikh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Elektrokardiografi

Prof. dr. Peter Kabo


1. Irama : Sinus
Bukan Sinus Atrial Fibrilasi
SVT
Irama JUNSION
60-100 x/menit (normal)
2. Laju QRS : HR?
Regularitas
3. Aksis : Normal
RAD/LAD
Superior Aksis
4. Interval PR : 0.20 Detik (Normal)
5. Morfologi
a. Gelombang P : Normal P.Pulmonal P.Mitral
b. Kompleks QRS : Q patologis
RSR pattern di V1&V2
Interval-QRS (0.08 detik)
c. Segmen ST : ST-elevasi, ST-depresi
d. Gel.T : Flat-T, Inverted-T, tall-T
PA interval : 0.01-0.45 detik
P dur : 0.06 ± 0.2 detik
Max : 0.1 detik
AH interval : 0.05-0.13 detik
PR-interval : ± 0.2 detik
Max : 0.24 detik
HV interval : 0.03-0.05 detik
PRS dur : ± 0.08 detik
Max : 0.1 detik
6.7 x 20 = 134x/menit

300 : 5.8 = 52x/menit

3.3 x 50 = 165x/menit
Gambar 3.2. Perhitungan aksis
A. Aksis Normal : Lead I: I= +4.5; lead aVF : +12.5; aksis
= 72°
B. Deviasi aksis ke kanan : Lead I = -10; lead aVF : +8; aksis
= +140°
C. Deviasi aksis ke kiri : Lead I = +5; lead aVF : -10; aksis =
- 60°
Atrial fibrillation / Flutter

• Valvular heart disease (+++ mitral valve)


• Manipulation of right atrium (canulation)
• Electrolyte disturbances
• Hypovolemia
• Hyperthyroidism http://www.emedu.org/
Atrial fibrillation / Flutter

• Valvular heart disease (+++ mitral valve)


• Manipulation of right atrium (canulation)
• Electrolyte disturbances
• Hypovolemia
• Hyperthyroidism http://www.emedu.org/
Sinus tachycardia

• Awake patient ( + Hypertension)


• Hypovolemia
• Hypoxia
• Hyperthyroidism
http://www.emedu.org/
Supraventricular tachycardia

• Abnormal rhythm after weaning from CPB


• May be poorly tolerated
• Amiodarone

http://www.emedu.org/
Supraventricular tachycardia

• Abnormal rhythm after weaning from CPB


• May be poorly tolerated
• Amiodarone

http://www.emedu.org/
Multifocal Atrial tachycardia

• Valve surgery (+++): Mitral, tricuspid


• COPD and advanced Pulmonary hypertension
http://www.emedu.org/
PVC (ESV)

• Bigeminism
PVC (ESV)

• paired
PVC (ESV)

• Polymorphic
PVC (ESV)

• Triplet
Ventricular tachycardia
Ventricular tachycardia

• Mechanical arrest or severe hypotension


• Great O2 consumption +++
• Before CPB: critical ischemia (Left main, severe
CAD)
• After CPB: Myocardial ischemia, electrolyte
disturbances
• electroshock
http://www.emedu.org/
1 Degree AV block
st

• Beta blockers
• Frequent in elderly
• AV node (valve surgery, MI) http://www.emedu.org/
2 Degree AV block type 2
nd

– Lesion to conduction tissues (AVR, MVR, TVR)

http://www.emedu.org/
3 Degree AV block
rd

– Lesion to conduction tissues (AVR, MVR, TVR)

http://www.emedu.org/
Permanent Pacemaker

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