Electrical Alternans
Abstract
Seorang perempuan, 50 tahun datang ke poli Aritmia dengan keluhan berdebar. Rekaman EKG 12-sadapan diperlihatkan pada gambar di bawah ini:Irama dasar rekaman EKG di atas adalah irama sinus yang dibuktikan dengan morfologi gelombang P yang berasal dari lokasi nodus sinoatrial yaitu negatif di aVR dan positif di sadapan II, III dan aVF. Perhatikan di sadapan aVF pada denyutan 1 interval PR memanjang hingga 280 mdet menunjukkan suatu blok AV derajat 1. Yang menarik adalah denyutan ke 2 dan ke 4 merupakan suatu atrial premature beat dengan morfologi QRS yang berbeda dari morfologi QRS pada denyutan 1. Sebaliknya denyutan ke 3 dan ke 5 yang merupakan denyut sinus pun memiliki kompleks QRS yang berlainan. Terlihat jelas bahwa perubahan morfologi QRS itu hanya tampak pada sadapan ekstremitas tetapi kurang terlihat pada sadapan prekordial.
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References
Shaw EG, Rottman. Electrical alternans. Medscape. Available at: http://emedicine.medscape.com/article/154706. Accessed 28 November 2013.
Laurita KR, Rosenbaum DS. Cellular mechanisms of arrhythmogenic cardiac alternans. Prog Biophys Mol Biol. 2008;97(2-3):332-347.
Green M, Heddle B, Dassen W, Wehr M, Abdollah H, Brugada P, Wellens HJ. Value of QRS alteration in determining the site of origin of narrow QRS supraventricular tachycardia. Circulation. 1983;68(2):368-373.
Laurita KR, Rosenbaum DS. Cellular mechanisms of arrhythmogenic cardiac alternans. Prog Biophys Mol Biol. 2008;97(2-3):332-347.
Green M, Heddle B, Dassen W, Wehr M, Abdollah H, Brugada P, Wellens HJ. Value of QRS alteration in determining the site of origin of narrow QRS supraventricular tachycardia. Circulation. 1983;68(2):368-373.
Published
2015-03-31
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How to Cite
Yuniadi, Y. (2015). Electrical Alternans. Indonesian Journal of Cardiology, 35(1), 65-6. https://doi.org/10.30701/ijc.v35i1.377
Section
Forum Aritmia
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