ECG or electrocardiograph was invented by a Dutch named Dr.

Willhelm
Einthoven in 1903, so he was awarded the Nobel Prize in 1924. The ECG
works on the principle that is quite simple. Where would a normal healthy
heart pumps blood throughout the body when stimulated by electrical signals
that move propagates along a predetermined path. ECG is a tool that tracks
the strength and direction of this electrical signal.

A lead that is equipped with a conductive material will be placed on different

parts of the body so as to enable tracking electrical signals to the heart from
different angles. If the heart's electrical signal travels lead heading to the
leads will produce a line that rose on the graph (positive deflection). If the
heart's electrical signal travels is moving away from the leads will produce a
line down (negative deflection). Picture of the heart's electrical signals travel
will then be drawn on a sheet of graph paper. In a normal healthy heart, an
ECG that represents a complete heart beats will look like the image below:

The first wave of the small size is called the P wave The P wave is the
electrical signal that begins in a group of cells called the sinoatrial node (SA
node). This signal will then run through the atrium causes both atria contract
and push blood into the ventricles below.

PR interval is a signal slowdown in clumps of cells called the atrioventricular

node (AV node). This delay allows time for the atrium to empty it into the
blood in the ventricle. The electrical signal then goes to the bundle of His and
parted to the left and right branches, and finally to the Purkinje fibers. The
electrical signals then stimulate the ventricles to contract and pump blood to
the lungs and throughout the body. These electrical signals travel
represented by the QRS complex of the ECG.
While the T wave is a process that describes when the ventricular
repolarization. This pattern is called a normal sinus rhythm. And a basic
overview of each ECG were normal healthy heart. Of course there is also a
normal variation in healthy individuals. For example, a badminton athletes
will have a high R waves, because the left ventricle is usually larger in
athletes than people who are not athletes. However, the picture of anything
outside the normal range will be analyzed in conjunction with the patient's
symptoms to make the diagnosis of work.

There are several types of common disorders. The PR interval is too long
so-called first-degree block (block first degree). Remember, every little box
on modern ECG strips representing 0.04 seconds on the horizontal axis. And
every big box representing 0.20 seconds. A QRS duration of more than 0.12
seconds may be caused by a slowdown in one or both branches of the
bundle of His, called a bundle branch block. P wave incomplete, and
combined with an irregular heartbeat may be a sign of disease atrial
fibrillation. And many other ECG rhythm abnormalities. And that usually
keeps the doctor or paramedic excited is when they see the elevation of the
ST segment in succession on several leads.

The interesting thing can be found in the chart ECG despite the extremely
rare, while the ECG showing a flat line, called asystole, but the heart is still
beating and produce an electrical signal. Because of this, to confirm the
death of the patient, the doctors usually have to search and find asystole in
more than one lead. The opposite is also possible, and more generally,
where the EKG chart still shows the activity of the heart, after a person dies
and their hearts no longer pump blood. This is called PEA (pulseless
electrical activity), which shows the rest of the heart's electrical system that
is still functioning despite his own heart muscle has died.

Interpretation of ECG results

Knowing the normal and abnormal ECG

1. calibration
Normal calibration is 1mV (10 small boxes/2 large boxes)
2. Rhythm
Normal heart rhythm is 50-100x / min *The latest guidelines
Sinus rhythm:P wave is followed by a complex rhythm QRS and T wave
-sinus rhythm : Mean heart rate between 50-100x / min

-sinus tachycardia: Mean heart rate> 100x / min

-sinus bradycardia: Mean heart rate less than 50 times / min

-sinus arrhythmia: Mean heart rate changes every second

3. Rate
The most easy to use formula1500/Number of small boxesbetween the gel.R - R
Example:

4. The P wave
Normal: High 1-3 small box
Positive in leads I, II, AVF

5. PR Interval
Normal: Duration 3-5 small box

6. QRS axis (using the QRS wave)

Normal Axis: Lead I and AVF (+)

-Menyimpang to right: Lead I (-) and AVF (+)
-Menyimpang left: Lead I (+) and AVF (+)
-Menyimpang great right: Lead I and AVF (-)
*(+): Climb down (-): go down

7. Wave QRS
High: 5-20 small box
duration: 1.5-3 small box
8. QT Interval
The duration of <10 small boxes

9. Form QRS

10. Wave U => sign

hypokalemia Normal: No / do not appear

11. ST segment
Normlanyaisoelectric(Parallel / touching the red line) or <1 small box

12. The T wave

-Positive (+) in Lead I, II, V3-V6
Negative (-) in Lead aVR
*(+): Climb down (-): go down