Overview ecg

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Overview ECG

OverviewECGYandi Ariffudin, dr

Limb lead (bipolar)

+/-+ -Extremity lead (unipolar)

Menggunakan terminal sentral sebagai titik nol

5Precordial lead (unipolar)

Kertas EKG

Kertas grafik garis horizontal dan vertical dengan jarak 1 mm. Garis lebih tebal terdapat pada setiap 5 mm. Garis horizontal menggambarkan waktu 1 mm = 0,04 5mm = 0,20. Garis vertikal menggambarkan voltase 1 mm = 0,1 milivolt10 mm = 1 milivolt.Kecepatan perekaman 25 mm/detik. Kalibrasi 1 milivolt yang menghasilkan defleksi setinggi 10 mm.

ECG Terminology

P wave : activation of the atriaPR interval: duration of AV conductionQRS complex:activation of right and left ventricular QRS duration: duration of ventricular muscle depolarizationPP interval: duration of atrial cycle (an indicator or atrial rate)RR interval: duration of ventricular cardiac cycle (an indicator of ventricular rateQT interval: duration of ventricular depolarization and repolarization

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

Normal ECGP waveWidth < 0.12 sHeight < 0.3 milliVoltAlways positive in lead II, negative in aVRPR intervalFrom the start of P wave to the start of QRS Normal duration 0.12 0.20 s QRS complexWidth 0.06 0.12 s (~ 0.10 s)Length varies among leadsQ first negative deflectionR first positive deflectionS negative deflection after RST segmentFrom the end of S to the start of T Normal : iso-electricalT wavePositive in lead I, II, V3 V6 and negative in aVR

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

Rhytme

KELAINAN

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

Determining the Heart RateRule of 300300/[number of large boxes between two R waves].only works for regular rhythms !!

300/7.5 large boxes = rate 40Six second methodsCount the number of R-R intervals in six seconds and multiply by 10 Useful for irregular rhythm average rateThere are 8 R-R intervals within 30 boxes. Multiply 8 x 10 = Rate 80 ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

Axis

Defleksi positifDefleksi negatif

aVF3600-1800I+900+00R A DL A D

36

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

P morphologyIndicate wave of atrial depolarizationNormal characteristic:Smooth and roundedUpright in leads I, II, aVF, aVLUpright or downward in lead IIIBiphasic in right precordial lead (V1,V2)P wave duration: 120 milliseconds (measured in the widest P wave)Amplitude in limb lead: < 0.25 mV and terminal negative deflection in V1 or V2 < 0.1 mV in depthP morphology

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

PR intervalMulai dari awal gelombang P sampai dengan permulaan kompleks QRSDurassi normal 0.12-0.2 detikPR interval

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

QRS durationWave of ventricular depolarization5-20 mm tallDuration 0.06-0.10/0.12 seconds

QRS morphology qRsRsRrSQRQ/QSRsRrSrQ waveAny pathological Q wave or not>1/3 of QRS complexQRQ/QSR wave progression

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

ST segmentBegins at J pointBetween ventricular depolarization and ventricular repolarizationGenerally isoelectric

J Poin

NON-STEMI / UAPECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

T waveVentricular repolarization, followed by ventricular relaxationPositive in lead : I, II, V3-V6Negative in lead avR

ECG REPORTINGRhythmQRS rateAxisP wavePR intervalQRS complexQRS durationST segmentT waveExtra systoles

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