1. HOW TO READ ELECTROCARDIOGRAPHY SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY (UIN), JAKARTA Dr. Yasmin Tadjoedin, Sp.JP

9. ECG INTERPRETATION 1.RATE 2.RHYTHM 3.AXIS 4.HIPERTROPHIC SIGNS 5.MYOCARDIAL INFARCTION 6.ARRHYTHMIA

10. STEPS IN ECG READING : Rhytm QRS Rate QRS Axis P wave PR Interval QRS Duration QRS Morphology ST Segmen Deviation T wave morphology U wave Others (LVH,LV Strain,BBB, QT interval) ECG conclusion NORMAL VALUES : PR Interval 0,12’’ - 0,20’’ QRS Duration 0,04’’ - 0,12’’ Normal Axis - 30 0 - + 110 0

11. 1. RATE Normal heart rate : 60 – 100 x/minutes > 100 x/minutes : Sinus Tachycardia < 60 x/minutes : Sinus Bradicardia Determination heart rate (normal paper speed 25 mm/s): 300 Count number of large square (bold boxes in one R – R’ interval) 1500 Count number of small square in one R – R’ intervals Number of QRS complex in 6 seconds, multiply by 10

13. 2. RHYTHM Normal cardiac rhythm : SINUS rhythm Sinus rhythm characteristics : Rate 60-100 bpm Constant R – R interval Negative P wave in aVR and positive di II P wave is always followed by QRS complex

14. 3. AXIS

17. 4. HYPERTROPHIC SIGNS LEAD II

18. LEAD V1

22. 5. MYOCARDIAL INFARCTION Ischemia Injury Necrosis

27. ANTERIOR INFARCTION

28. INFERIOR INFARCTION

29. POSTEROLATERAL INFARCTION

30. ARRHYTHMIA

31. AV BLOCK

33. Complete heart block

34. COMPLETE LEFT BUNDLE BRANCH BLOCK (LBBB)

35. COMPLETE RIGHT BUNDLE BRANCH BLOCK (RBBB)

42. WHAT’S WRONG?? Lead Error: V1 and V3 are Transposed! In this normal 12-lead ECG the V1 and V3 chest electrodes are interchanged. Experienced ECG interpreters should be able to spot this lead placement error.