ARITMIABasuki RahmatDep. Kardiologi dan Kedokteran Vaskuler FK UNRAM Mataram

ARITMIATerlalu cepat? TakikardiaTerlalu lambat? BradikardiaNormal SR: 60-100 bpm?

BradikardiaGangguan Pembentukan ImpulsSinus pause, sinus arrestSick sinus syndromeGangguan konduksi impulsSinoatrial (SA) blokAtrio-ventrikular (AV) blok

Klasifikasi TakikardiaDengan QRS sempitRegulerIregulerDengan QRS lebar

Takikardia dengan QRS sempitDengan irama ireguler:Sinus aritmiaAtrial fibrilasiAtrial flutter (AFL) dengan varying blockAtrial takikardi (AT) dengan varying blockDengan irama regular:Atrioventricular Reprocicating Tachycardia (AVRT)Atrioventricular Nodal Reentrant Tachycardia (AVNRT)AFLATJunctional Tachycardia (JT)Narrow complex Ventricle Tachycardia (VT)

Takikardia dengan QRS lebarVTSupraventrikular Takikardi (SVT) dengan bundle branch block (BBB)AberrancyPre-existing BBBSVT dengan pre-eksitasiAVRT (antidromic)AVNRT dengan pre-eksitasiAT dengan pre-eksitasi

Atrial fibrillationAtrial flutter

AVRT AVNRTVTVFSNRTATJTLokasi dan mekanisme aritmia

Rhythms produced by Conduction BlockAV Block 1st degree AV BlockType 1 2nd degree AV BlockType 2 2nd degree AV Block3rd degree AV Block

1st Degree AV BlockECG Characteristic:Prolongation of the PR interval, which is constant All P waves are conducted

Type 1 2nd Degree AV Block ECG Characteristic:1. Progressive prolongation of the PR interval until a P wave is not conducted2. As the PR interval prolongs, the RR interval actually shortens

ECG Characteristic:Constant PR intervalIntermittent failure to conductType 2 2nd Degree AV Block

3rd Degree (Complete) AV BlockECG Characteristic:No Relationship between P waves and QRS complexesRelatively constant PP intervals and RR intervalsGreater number of P waves than QRS complexes

SUPRAVENTRIKULAR TAKIKARDI

Basuki Rahmat11/18/2009

Basuki Rahmat

SUPRAVENTRICULAR TACHYCARDIABasuki Rahmat11/18/2009

Basuki Rahmat

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 depolarizationBasuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

ATRIAL FIBRILATIONBasuki Rahmat11/18/2009

Basuki Rahmat

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 QRSBasuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

JUNCTIONAL RHYTMBasuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

JUNCTIONAL RHYTMBasuki Rahmat11/18/2009

Basuki Rahmat

Irama VentricularBasuki Rahmat11/18/2009

Basuki Rahmat

VESSRVES (Ventricular Extra Sistole)Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

VESBasuki Rahmat11/18/2009

Basuki Rahmat

SRSRSRSRSRSRVESVESSinus rhythm with Multifocal VESBasuki Rahmat11/18/2009

Basuki Rahmat

Ventricular TachycardiaBasuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

= 1.286 N = 0.657 N Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Ventricular FibrillationBasuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

Basuki Rahmat11/18/2009

Basuki Rahmat

PULSELESS ELECTRICAL ACTIVITY (PEA)Basuki Rahmat11/18/2009

Basuki Rahmat

*******