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SA node
Sumber impuls normal/
alamiah , 60 100
AV node
Bisa mengeluarkan
impuls 40-60x/menit
Berkas His
Serabut Purkinje
Ventrikel
Bisa mengeluarkan impuls
20-40 x/menit
Tachyarrhythmia
(rate >100 x/min)
Bradyarrhytmia
(rate < 60 X/min)
Drugs
- anti-arrhytmia
- sympathomimetic.
- B2 agonis, cocaine, anti depresants
(tricyclic), Aminophylline, caffeine.
- alcohol.
Metabolic abnormalities.
- Electrolyte (low K, Na, Ca, Mg )
- Hypoximia, Hypercarbia.
- Acidosis
0 Endocrine abnormalities
-Thyrotoxicosis, Phaeochrocytoma.
Miscellaneous.
Febrile illness
Emotional stress
Smoking
Fatigue.
Symptoms
Palpitations: nontachycardiac; rapid and regular; rapid and
irregular (regularly irregular or irregularly irregular).
Abrupt or accelerating onset and termination?
Dyspnea
Chest discomfort
Syncope; nearly blacked out; syncope with spell
Polyuria
Cardiac arrest
Signs
Heart rate and pulses: regularity; amplitude; deficit
Hypotension
Hypoperfusion
Failure of impulse
formation
Sinus Bradycardia
Sick Sinus Syndrome
AV conduction
abnormalities
1st and 2nd AV Block
Total AV Block
BBB (Bundle Branch
Block)
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
First-degree AV block
Rhythm : Regular
Rate
: Usually normal
P wave : Sinus P wave present; one P wave to each QRS
PR
: Prolonged ( greater than 0.20 seconds )
QRS
: Normal
Third-degree AV block
Rhythm : Regular
Rate
: 40 60 if block in His bundle;
30 40 if block involves bundle branches
P wave : Sinus P wave present; bear no relationship to QRS;
can be found hidden in QRS complexes and T waves
PR
: Varies greatly
QRS : Normal if block in His bundle;
wide if block involves bundle branches