Ecg Pathology 02
Ecg Pathology 02
Ecg Pathology 02
Changes
ECG Changes
•Rhythm
•Frequency
Diagnosing ECG
Electrical conduction
Sinoatrial
Node
Atrioventricular
Node
Cardiac Physiology Electrocardiography Diagnosis
P T
Q
S
Cardiac Physiology Electrocardiography Diagnosis
R 1 sec
P T
Q
S
0.5 Sec
ECG Normal
Rhythm (Irama)
• Sinus
• Arrythmia
Frequency
• Normal
• Tachycardia
• Bradycardia
Morphology
• Axis
• Besaran depolarisasi
Arrythmia
SK
Arrhytmia
Tachyarrhythmia Bradyarrhytmia
(rate >100 x/min) (rate < 60 X/min)
• Duration of QRS
• Regularity of QRS
• P wave ??
QRS complex
Regular / irregular ?
QRS complex
Normal-looking QRS complex?
Wide / narrow ?
P wave ?
narrow-QRS
Supraventricular
Sinus Tachycardia Atrial Fibrillation
Tachycardia
Atrial Flutter
Atrial Flutter :
-The result of a re-entry circuit within
the atria
-Irregular / regular QRS rate
-Narrow QRS complex
-Rapid P waves (300x/min), “sawtooth”
Atrial Flutter
Supraventricular Tachycardia ( SVT )
reentry via accessory pathway
PSVT :
-due to re-entry mechanism
-narrow QRS complex
-regular
-retrograde atrial depolarization
-P wave ?
PSVT (Paroxysmal SupraVentricular Tachyradia)
SVT
SVT
Atrial Fibrillation :
narrow-QRS
Supraventricular
Sinus Tachycardia Atrial Fibrillation
Tachycardia
Atrial Flutter
Atrial Fibrillation :
Preventricular Contractions
• Coffee
• Cigarettes
• Sleep deprivation
• Pathology
Cardiac Physiology Electrocardiography Diagnosis
Normal ECG
SR
VES
VES Unifocal
VES VES
SR SR
SR SR SR SR
Sinus rhythm with VES couplet
Sinus Rhythm with VES, R on T
wide-QRS tachycardia :
Supraventricular and Ventricular origin
wide-QRS
Ventricular
SVT + BBB
Fibrillation
Ventricular
Tachycardia
Ventricular Tachycardia
VT
VT
VT
wide-QRS tachycardia :
Supraventricular and Ventricular origin
wide-QRS
Ventricular
SVT + BBB
Fibrillation
Ventricular
Tachycardia
Ventricular Fibrillation
Cardiac Physiology Electrocardiography Diagnosis
Normal ECG
Ventricular Fibrilation
• Ischemia
• Electric Shock
VF
Torsade de pointes
Bradyarrhytmia
(rate < 60 x/min)
Atrioventricular Block
• Ischemia
• Nodal Compression
• Nodal Inflamation
• Extreme Stimulation
ATRIO-VENTRICULAR BLOCK
1st degree AV block
Prolonged PR interval
2ND AV Block Type 1 :
Wenkebach
Missing QRS
2nd degree AV block, type 1
Missing QRS
Cardiac Physiology Electrocardiography Diagnosis
Normal ECG
P P P P P P P
LBBB
The
Deadly
Rhythms
PEA
VT VF (Pulseless
Electrical
Activity)
A systole
Summary
Cardiac Arrthythmias
• Tachycardia: abnormally fast heart rate
• Bradycardia: Abnormally slow heart rate
• Incomplete Atrioventricular Block:
Prolonged P-R interval
• Complete Atrioventricular Block: P waves
and QRS complexes become dissociated
• Fibrillation: Complete lack of coordination
SUMMARY
• Atria
• Ventricles
Cardiac Physiology
• Nodes
Electrocardiography • Electrical
Propagation
• AV Block
Cardiac Physiology • PVCs
• V-Fib
Electrocardiography