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ARITMIA JANTUNG



   Departemen Kardiologi dan Kedokteran Vaskular
Divisi Kardiovaskular, Departemen Ilmu Penyakit Dalam
            FK-UNPAD/RS Hasan Sadikin
                      Bandung


                                                        1
Atrium
           kiri


Atrium
kanan

                     Ventrikel
                       kiri
         Ventrikel
          kanan




                                 2
+       +           –    –   –                +         +
    –   –   –           + + +                     –    –     –
    +       +           –    –   –                +         +
                    1
                            2
    +
0
    –                                  3
                0

                                              4
                            AR       RR

                                 AR, absolute refractory period
                                 RR, relative refractory period



    +
    –                                                             3
Sino-atrial
node (SA
   node)




              4
Atrio-ventricular node
             (AV node)

Sino-atrial
node (SA                         His bundle
   node)


                                       Left bundle branch




 Right bundle
    branch
                            Purkinje
                                                       5
LA
                                                     (HB)
                         RA
           (SAN)                      V
                                 V        (BB)
                (AVN)



                                 (BB)

                                 R
                   HB

SAN        AVN          BB
       P                                         T



  RA                         Q        S
           LA
                                                            6
                                 V
R               R   R




            Q           S

    R               R

                        R’




Q       S   QS          S    7
EKG normal (irama sinus)




                           8
Gangguan
          pembentukan impuls



ARITMIA



          Gangguan hantaran

               impuls
ARITMIA JANTUNG:

GANGGUAN PEMBENTUKAN IMPULS




                              10
Otomatisitas SA node
         menurun




 Frekuensi
   intrinsik
(bradikardia)
Otomatisitas SA node
                                    normal sedangkan
                                    otomatisitas fokus di
                                    atrium atau junction
                                    atau ventrikel meningkat
                                    melebihi SA node




 Frekuensi atrial atau junctional atau
ventrikuler   melebihi sinus (takikardia)
IRAMA ATRIAL
Atrial tachycardia




Atrial fibrilation




  Atrial flutter
IRAMA JUNCTIONAL
IRAMA
Ventricular tachycardia    VENTRIKULER




 Ventricular fibrilation
Ventricular premature beat




Ventricular bigemini (monomorphic)




Ventricular bigemini (polymorphic)
“R on T”




VT dicetuskan oleh VES “R on T”
ARITMIA JANTUNG:

GANGGUAN HANTARAN IMPULS

  (GANGGUAN KONDUKSI)



                           23
Blok atrio-ventrikular

                (AV block)
GANGGUAN
HANTARAN



           Blok intraventrikular

           (bundle-branch block)
Blok atrio-ventrikular

     ( AV block )


                         25
Mobitz type I
Second-degree AV block




 Mobitz type II




                         28
Blok intraventrikular

( bundle-branch block )


                          30
Right bundle
branch
block
(RBBB)




               31
Left bundle
branch block
(LBBB)




               32

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Notas do Editor

  1. The cardiac transmembrane potential consists of five phases: phase 0, upstroke or rapid depolarization; phase 1, early rapid repolarization; phase 2, plateau; phase 3, final rapid repolarization; and phase 4, resting membrane potential and diastolic depolarization