how to read ECG for dummy

1. Yandi Ariffudin, dr

3. - +/-
+

4. Menggunakan terminal sentral sebagai titik nol

9.  Kertas grafik garis horizontal
dan vertical dengan jarak 1 mm.
 Garis lebih tebal terdapat pada
setiap 5 mm.
 Garis horizontal
menggambarkan waktu
1 mm = 0,04“
5mm = 0,20“.
 Garis vertikal menggambarkan
voltase
1 mm = 0,1 milivolt
10 mm = 1 milivolt.
 Kecepatan perekaman 25
mm/detik.
 Kalibrasi 1 milivolt yang
menghasilkan defleksi setinggi
10 mm.

12.  P wave : activation of the atria
 PR interval: duration of AV
conduction
 QRS complex:activation of right and
left ventricular
 QRS duration: duration of ventricular
muscle depolarization
 PP interval: duration of atrial cycle
(an indicator or atrial rate)
 RR interval: duration of ventricular
cardiac cycle (an indicator of
ventricular rate
 QT interval: duration of ventricular
depolarization and repolarization

14. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

15.  P wave
 Width < 0.12 s
 Height < 0.3 milliVolt
 Always positive in lead II, negative in aVR
 PR interval
 From the start of P wave to the start of QRS
 Normal duration 0.12 – 0.20 s
 QRS complex
 Width 0.06 – 0.12 s (~ 0.10 s)
 Length varies among leads
 Q  first negative deflection
 R  first positive deflection
 S  negative deflection after R
 ST segment
 From the end of S to the start of T
 Normal : iso-electrical
 T wave
 Positive in lead I, II, V3 – V6 and negative in aVR

16. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

18. KELAINAN

27. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

28.  Rule of 300
 300/[number of large boxes between two R waves].
 only works for regular rhythms !!
300/7.5 large boxes = rate 40
 Six second methods
 Count the number of R-R intervals in six seconds and multiply by
10
 Useful for irregular rhythm  average rate
There are 8 R-R intervals
within 30 boxes. Multiply 8 x
10 = Rate 80

29. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

31. Defleksi positif Defleksi negatif

33. —
3600
I
+
-
1800 00
aVF
+
900

38. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

39.  Indicate wave of atrial depolarization
 Normal characteristic:
1. Smooth and rounded
2. Upright in leads I, II, aVF, aVL
3. Upright or downward in lead III
4. Biphasic in right precordial lead (V1,V2)
5. P wave duration: 120 milliseconds (measured in
the widest P wave)
6. Amplitude in limb lead: < 0.25 mV and terminal
negative deflection in V1 or V2 < 0.1 mV in depth

42. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

43.  Mulai dari awal gelombang P sampai dengan
permulaan kompleks QRS
 Durassi normal 0.12-0.2 detik

49. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

50.  Wave of ventricular depolarization
 5-20 mm tall
 Duration 0.06-0.10/0.12 seconds

52. QRS morphology
qRs Rs R rS
QR Q/QS rSr’
RsR’

53.  Any pathological Q wave or not
• >1/3 of QRS complex
QR Q/QS

59. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

60.  Begins at J point
 Between ventricular depolarization and
ventricular repolarization
 Generally isoelectric

61. J Poin

68. NON-STEMI / UAP

69. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

70.  Ventricular repolarization, followed by
ventricular relaxation
 Positive in lead : I, II, V3-V6
 Negative in lead avR

72. ECG REPORTING
1. Rhythm
2. QRS rate
3. Axis
4. P wave
5. PR interval
6. QRS complex
7. QRS duration
8. ST segment
9. T wave
10. Extra systoles

77. Sekian