Arrhytmia

Tachyarrhythmia (rate >100 x/min)

Bradyarrhytmia(rate < 60 X/min)

• QRS sempit (<0.12 ms)• QRS lebar (>0.12 ms)

• AV blok derajat 1, 2 & 3• RBBB & LBBB

Diagnostic Tachyarrhytmia

• Lebar gel. QRS

• Keteraturan gel. QRS

P wave ??

QRS complex Teratur / tidak teratur ?

QRS complexSempit / lebar ?

P wave ?

Hubungan antara P and QRS ?

QRS sempit : Supraventricular origin

QRS sempit

Irama TeraturIrama

Tidak teratur

Atrial Flutter

Sinus TachycardiaSupraventricular

TachycardiaAtrial Fibrillation

SVT :

-due to re-entry mechanism-narrow QRS complex-regular-retrograde atrial depolarization-P wave ?

Atrial Fibrillation :

-from multiple area of re-entry within atria-or from multiple ectopic foci-irregular, narrow QRS complex-very rapid atrial electrical activity (400-700 x/min).-no uniform atrial depolarization

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”

Junctional rhythm:

-AV junction can function as a pace maker (40-60 x/min).-due to the failure of sinus node to initiate time impulse or conduction problem.-normal-looking QRS.-retrograde P wave.-P wave may preceede, coincide with, or follow the QRS

VES

SR

VENTRIKEL EXTRA SYSTOLE

SR SR SR SRSR SR

VES VES

Sinus rhythm with Multifocal VES

Sinus rhythm with VES couplet

Sinus Rhythm with VES, R on T

SVT

AF rapid

QRS Lebar : Ventricular origin

QRS lebar

Irama TeraturIrama

tidak teratur

Ventricular Tachycardia

Ventricular Fibrillation

Ventricular Tachycardia

Torsade de Pointes

Ventricular Fibrillation

VT

VT

VF

Torsade de Pointes

Bradyarrhytmia(rate < 60 x/min)

Failure of impulse formation

• Sinus Bradycardia• Sick Sinus Syndrome

AV conduction abnormalities

• 1st and 2nd AV Block• Total AV Block• BBB (Bundle Branch

Block)

Prolonged PR interval

1st degree AV block

Missing QRS Missing QRS

2nd degree AV block, type 1

2nd degree AV block, type 2

Missing QRS

P P P P P P P

QRS QRS QRS

Total AV Block / 3rd degree AV block

2ND AV Block Type 1 : Wenkebach

Sick Sinus Syndrome

RBBB

LBBBLBBB