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INTERPRETASI

ELEKTROKARDIOGRAFI

PENDRIK TANDEAN
CARDIAC CENTRE
RS. WAHIDIN SUDIROHUSODO MAKASSAR

ELEKTROKARDIOGRAM
SUATU

REKAMAN GRAFIK DARI


POTENSIAL LISTRIK YANG
DIHASILKAN BERSAMA DENGAN
DENYUT JANTUNG.
JANTUNG ADALAH ORGAN UNIK
KARENA MEMPUNYAI KEMAMPUAN
KONTRAKSI SECARA RITMIK DAN
OTONOM.

Chest Leads
6 Unipolar leads
Also known as precordial leads
V1, V2, V3, V4, V5 and V6 - all positive

Atrial depolarization, P-wave

Ventricular depolarization, Q

Ventricular depolarization, R

Ventricular depolarization, S

Ventricular repolarization, T

ECG & dipole movement

Right sided chest leads are much more sensitive to the presence of right
ventricular infarction. The most useful lead is lead V4R (an electrode is place
over the right fifth intercostal space in the mid-clavicular line).

ECG diagnosis

QRS waveform nomenclature

qR

qRs

Qr

Rs

rS

qs

Qrs

rSr

QS

rSR

The 10 rules for a normal ECG


I II III

aVR aVL aVF

V1 V2 V3

V4 V5 V6

.2

DEVIASI AXIS

Rule 1
1.0

Millivolts

0.5

PR
interval

PR interval should
be 120 to 200
milliseconds or 3 to
5 little squares

T
P
Q

-0.5

200

400

Milliseconds

600

Rule 1
1.0

Millivolts

0.5

PR
interval

PR interval
should be
120 to 200
milliseconds or
3 to 5 little
squares

T
P
Q

-0.5

200

400
Milliseconds

600

Rule 2
1.0

Millivolts

0.5

The width of the


QRS complex
should not exceed
110 ms, less than 3
little squares

T
P
Q

-0.5

QRS
0

200

400

Milliseconds

600

Rule 3
I II III

aVR aVL aVF

The QRS
complex should
be dominantly
upright in leads I
and II

Rule 4

I II III

aVR aVL aVF

QRS and T waves


tend to have the
same general
direction in the limb
leads

Rule 5

All waves are negative


in lead aVR
T

Rule 6
V1

V2

V3

V4

V5

V6

The R wave in the precordial leads must grow from V1 to at


least V4

Rule 7
I II III

aVR aVL aVF

V1 V2 V3

V4 V5 V6

The ST segment should start isoelectric except in V1


and V2 where it may be elevated

Rule 8
I II III

aVR aVL aVF

V1 V2 V3

V4 V5 V6

The P waves should be upright in I, II, and V2 to V6

Rule 9
I II III

aVR aVL aVF

V1 V2 V3

V4 V5 V6

There should be no Q wave or only a small q less


than 0.04 seconds in width in I, II, V2 to V6

Rule 10
I II III

aVR aVL aVF

V1 V2 V3

V4 V5 V6

The T wave must be upright in I, II, V2 to V6