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Conduction System
SA Node
Internodal branch
AV Node
Hiss Bundle
Purkinje Fiber
Contraction
The Electrocardiogram ( ECG )
• P wave : atrial
depolarisation R
• QRS complex :
ventricular T
depolarisation P
• T wave : ventricular
repolarisation Q
S
• Atrial repolarisation
hidden by QRS
P Wave
P Pulmonale
P Mitrale
PR Interval
QRS Complex
ST Segment
T Wave
Normal Sinus Rhythm
Rhythm : Regular
Rate : 60 – 100
P wave : Normal in configuration; precede each QRS
PR : Normal ( 0. 12 – 0.20 seconds )
QRS : Normal ( less than 0.12 seconds )
First-degree AV block
Rhythm : Regular
Rate : Usually normal
P wave : Sinus P wave present; one P wave to each QRS
PR : Prolonged ( greater than 0.20 seconds )
QRS : Normal
Second -degree AV block, Mobitz I
Rhythm : Irregular
Rate : Usually slow but can be normal
P wave : Sinus P wave present;
some not followed by QRS complexes
PR : Progressively lengthens
QRS : Normal
Second-degree AV block, Mobitz II
Rhythm : Regular
Rate : 40 – 60 if block in His bundle;
30 – 40 if block involves bundle branches
P wave : Sinus P wave present; bear no relationship to QRS;
can be found hidden in QRS complexes and T waves
PR : Varies greatly
QRS : Normal if block in His bundle;
wide if block involves bundle branches
Wolff-Parkinson-White syndrome
ST depresi dan perubahan gelombang T
Bentuk segmen ST :
Gelombang T hiperakut
kadang2 merupakan satu-satunya
perubahan EKG yang terlihat
Anatomi Koroner dan EKG 12 sandapan
• Sandapan II, III dan avF menghadap dinding inferior ventrikel kiri
Unstable angina
Acute anteroseptal myocardial infarction.
Hyperacute T-wave changes are noted
Acute anterolateral myocardial infarction
High lateral infarction
Inferior myocardial infarction
Acute inferoposterior myocardial infarction
LVH
LVH
LVH
RVH
RVH
RVH