ARITMIA

ARITMIA

ARITMIA

PEMBIMBING: DR. YAHYA, SP.JP

PEMBIMBING: DR. YAHYA, SP.JP

DISUSUN OLEH:

DISUSUN OLEH:

ASRI ALIFA SHOLEHAH (1102010037)

ASRI ALIFA SHOLEHAH (1102010037)

NABILA (1102010197)

NABILA (1102010197)

KEP

KEPANITERAAN KLINIK ANITERAAN KLINIK STSTASE INTERNAASE INTERNA

ILMU PENYAKIT JANTUNG DAN PEMBULUH DARAH ILMU PENYAKIT JANTUNG DAN PEMBULUH DARAH

RS POLRI RADEN SAID SUKATO RS POLRI RADEN SAID SUKATO

DEFINISI

DEFINISI

I!"! #!$% &'!$ &!*!+

I!"! #!$% &'!$ &!*!+

!-$'* SA, -!"! #!$% /-! /!/'

$'* SA, -!"! #!$% /-! /!/'

*!+-'$ &!*!+ !- $'* SA,

*!+-'$ &!*!+ !- $'* SA,

'$*- '!$% !- 04"$-/

'$*- '!$% !- 04"$-/

(S-$'* B!-!-) !/!' +&-5

(S-$'* B!-!-) !/!' +&-5

!-1004"$-/ (*-$'* /!-!-)

1004"$-/ (*-$'* /!-!-)

EPIDEMIOLOGI

EPIDEMIOLOGI

Di Ameri&$' (ebi) d$ri *%0'000 or$+, dir$-$. di

Di Ameri&$' (ebi) d$ri *%0'000 or$+, dir$-$. di

r#m$) /$&i.

r#m$) /$&i.

&$r

&$r

e+$

e+$

$ri.mi$

$ri.mi$

/e.i$

/e.i$

.$)#++$

.$)#++$

A.ri$(

A.ri$(

3bri($/i

3bri($/i

me+,e+$i4

me+,e+$i4

2'5

2'5

7#.$

7#.$

or$+,

or$+,

di

di

$meri&$

$meri&$

#.$r$ d$+ '% 7#.$ or$+, di ero$' .er#.$m$ $+,

#.$r$ d$+ '% 7#.$ or$+, di ero$' .er#.$m$ $+,

ber#/i$ ($+7#.

ber#/i$ ($+7#.

Di $meri&$' &ir$8&ir$ 9% : or$+, $+, .er&e+$

Di $meri&$' &ir$8&ir$ 9% : or$+, $+, .er&e+$

$.ri$( 3bri($/i ber#/i$ ;% .$)#+ $.$# b$)&$+ (ebi)

$.ri$( 3bri($/i ber#/i$ ;% .$)#+ $.$# b$)&$+ (ebi)

.#$

.#$

A" mer#$&$+ $ri.mi$ $+, $(i+, /eri+, .er7$di

A" mer#$&$+ $ri.mi$ $+, $(i+, /eri+, .er7$di

de+,$+ rev$(e+/i 0' : $d$ ,o(o+,$+ #/i$<;%

de+,$+ rev$(e+/i 0' : $d$ ,o(o+,$+ #/i$<;%

.$)#+ d$+ me+i+,&$. 10 : $d$ &e(omo& #/i$ =

.$)#+ d$+ me+i+,&$. 10 : $d$ &e(omo& #/i$ =

9% .$)#+  Di Ameri&$ U.$r$' rev$(e+/i A"

9% .$)#+  Di Ameri&$ U.$r$' rev$(e+/i A"

dier&ir$&$+ me+i+,&$. d#$ /$m$i .i,$ &$(i (i$.

ETIOLOGI

ETIOLOGI

 

 

Per$d$+,$+ 7$+.#+,'

Per$d$+,$+ 7$+.#+,'

 

 

G$+,,#$+ /ir&#($/i &oro+er

G$+,,#$+ /ir&#($/i &oro+er

 

 

K$r

K$r

e+$ ob$.

e+$ ob$.

>i+.o&/i&$/i?

>i+.o&/i&$/i?

 

 

G$+,,#$+

G$+,,#$+

&e/eimb$+,$+

&e/eimb$+,$+

e(e&.ro(i.

e(e&.ro(i.

>)ier&$(emi$' )io&$(emi$?

>)ier&$(emi$' )io&$(emi$?

 

 

G$+,,#$+ $d$ e+,$.#r$+ /#/#+$+ /$r$@

G$+,,#$+ $d$ e+,$.#r$+ /#/#+$+ /$r$@

$#.o+om $+, meme+,$r#)i &er7$ d$+

$#.o+om $+, meme+,$r#)i &er7$ d$+

ir$m$ 7$+.#+,

ETIOLOGI

ETIOLOGI

   

G$+,,#$+ /i&o+e#ro.i& d$+ /#/#+$+ /$r$@

G$+,,#$+ /i&o+e#ro.i& d$+ /#/#+$+ /$r$@

#/$.

#/$.

 

 

G$+,,#$+ me.$bo(i >$/ido/i/'

G$+,,#$+ me.$bo(i >$/ido/i/' $(&$(o/i/?

$(&$(o/i/?

 

 

G$+,,#$+

G$+,,#$+

e+do&ri+

e+do&ri+

>)ier.iroidi/me'

>)ier.iroidi/me'

)io.iroidi/me?

)io.iroidi/me?

 

 

G$+,,#$+

G$+,,#$+

ir$m$

ir$m$

7$+.#+,

7$+.#+,

$&ib$.

$&ib$.

,$,$(

,$,$(

 7$+.#+,

 7$+.#+,

 

 

G$+,,#$+ ir$m$ 7$+.#+, &$re+$ &$rmio$.i

G$+,,#$+ ir$m$ 7$+.#+, &$re+$ &$rmio$.i

$.$# .#mor 7$+.#+,

$.$# .#mor 7$+.#+,

 

 

G$+,,#$+ ir$m$ 7$+.#+, &$re+$ e+$&i.

G$+,,#$+ ir$m$ 7$+.#+, &$re+$ e+$&i.

de,e+er$/i

>3bro/i/

//.em

&o+d#&/i

de,e+er$/i

>3bro/i/

//.em

&o+d#&/i

 7$+.#+,?

 7$+.#+,?

6LASIFI6ASI

6LASIFI6ASI

 

 

G$+,,#$+ im#(/

G$+,,#$+ im#(/

› ›

SA Node

SA Node

› ›

A.ri$(

A.ri$(

›

›

A 7#+.io+

A 7#+.io+

›

›

e+.ri&e(

e+.ri&e(

 

 

G$+,,#$+ /i/.em &o+d#&/i

G$+,,#$+ /i/.em &o+d#&/i

›

›

 T

 T

em$. b(o&

em$. b(o&

›

›

Der$7$. b(o&

Der$7$. b(o&

›

 

 

G$+,,#$+ Im#(/

G$+,,#$+ Im#(/

›

›

Ir$m$ /i+#/

Ir$m$ /i+#/

Si+#/ Br$di&$rdi

Si+#/ Br$di&$rdi

Si+#/ T$&i&$rdi$

Si+#/ T$&i&$rdi$

Si+#/ Arre/.

Si+#/ Arre/.

›

›

Ir$m$ A.ri$(

Ir$m$ A.ri$(

A.ri$( "(#..er

A.ri$( "(#..er

A.ri$( "

A.ri$( T$&i&$rdi$

A.ri$( T$&i&$rdi$

E&/.r$/i/.o( A.ri$(

E&/.r$/i/.o( A.ri$(

›

›

Ir$m$ J#+.io+$(

Ir$m$ J#+.io+$(

A

A

 J#+.

 J#+.io+$(

io+$(

.$&i&$rdi$

.$&i&$rdi$

$ro&/im$(

$ro&/im$(

A

A

 J#+

 J#+

.io+$(

.io+$(

E&/.r$/i/.o(

E&/.r$/i/.o(

›

›

Ir$m$ e+.ri&#(er

Ir$m$ e+.ri&#(er





_{e+.ri&e( E&/.r$/i/.o( >ES?}

_{e+.ri&e( E&/.r$/i/.o( >ES?}





_{ES #+i@orm .$# #+i@o&$(}

_{ES #+i@orm .$# #+i@o&$(}







_{ES Bi,emi+i}

_{ES Bi,emi+i}





_{ES Tri,emi+i}

_{ES Tri,emi+i}





_{ES C#$dri,emi+i}

_{ES C#$dri,emi+i}







_{e+.ri&#($r T$&i&$rdi$ >T?}

_{e+.ri&#($r T$&i&$rdi$ >T?}





_{e+.ri&e( "ibri($/i >"?}

_{e+.ri&e( "ibri($/i >"?}



 

 

G$+,,#$+

G$+,,#$+ K

K

o+d#&/i

o+d#&/i

›

›

B(o& SA Node

B(o& SA Node

›

›

G$+,,#$+ A B(o&

G$+,,#$+ A B(o&







A b(o& der$7$. II

A b(o& der$7$. II





Mobi. .ie 1 >Fe&e+b$) B(o&?

Mobi. .ie 1 >Fe&e+b$) B(o&?





 

 

G$+,,#$+ $d$ Ser$b#. HIS

G$+,,#$+ $d$ Ser$b#. HIS

›

›

LBBB

LBBB

›

PATO"ISIOLOGI

PATO"ISIOLOGI

 

 

G$+,,#$+ Pembe+.#&$+ Im#(/

G$+,,#$+ Pembe+.#&$+ Im#(/

›

›

Ke($i+$+ $#.om$.i/$/i

Ke($i+$+ $#.om$.i/$/i

›

›

 T

 T

ri,,er $#.om$.i/$/i

ri,,er $#.om$.i/$/i

 

 

G$+,,#$+

G$+,,#$+ K

K

o+d#&/i

o+d#&/i

›

›

 Re-entry 

 Re-entry 

›

›

 Concealed conduction

 Concealed conduction

>&o+d#&/i $+,

>&o+d#&/i $+,

.er/emb#+i

.er/emb#+i

›

GEJ

GEJ

ALA

ALA

KLINIS

KLINIS

 

 

P$(i.$/i

P$(i.$/i

 

 

P#/i+,

P#/i+,

 

 

Se/$& +$@$/

Se/$& +$@$/

 

 

Neri d$d$

Neri d$d$

 

 

Ke(e($)$+

Ke(e($)$+

 

 

Pe+#r#+$+ &e/$d$r$+

Pe+#r#+$+ &e/$d$r$+

 

DIAGNOSIS

DIAGNOSIS

 

 

E(e.ro$rdio,r$m >EG?

E(e.ro$rdio,r$m >EG?

 

 

Amb#($.or mo+i.or

Amb#($.or mo+i.or

 

 

S.re// .e/.

S.re// .e/.

 

 

E)o$rdio,r$m

E)o$rdio,r$m

 

 

$rdi$ $.)e.eri$.io+

$rdi$ $.)e.eri$.io+

 

 

E(e.ro)/io(o, /.#d >EPS?

E(e.ro)/io(o, /.#d >EPS?

 

 T

 T

A

A

T

T

ALAKS

ALAKS

ANA

ANA

 

 

"$rm$&o.er$i

"$rm$&o.er$i

›

›

A+.i $ri.mi$

A+.i $ri.mi$

›

Pe+,ob$.$+ Ari.mi$

Pe+,ob$.$+ Ari.mi$

N N MM!!$$--**""  66!! GG++$$%%!!$$ 88!!/ / AA//-- !$ D*-* !$ D*-* N!"! N!"! G$-  G$-  E E S!"-$% S!"-$% 1

1$$ $$..88$$. /. /..$b$bi(i(i/i/$$//ii membr$+ membr$+ $.8$. i+i $.8$. i+i me+,#r$+,i me+,#r$+,i &ee&

&ee&$$+ $$+ membr$+membr$+ /e(87$+.#+, #+.#& /e(87$+.#+, #+.#& r$+,/$+,$+ $&ib$. r$+,/$+,$+ $&ib$. e+,)$mb$.$+ e+,)$mb$.$+ em$/#&$+ io+ N$ em$/#&$+ io+ N$ &e membr$+ d$+ &e membr$+ d$+ er($mb$.$+ er($mb$.$+ deo($ri/$/i+$ deo($ri/$/i+$ Ke(omo& Ke(omo& Ki+idi+ Ki+idi+ $.8$. i+i $.8$. i+i $+.$r$( $i+ $+.$r$( $i+ memer$+7$ memer$+7$ +, m$/$ +, m$/$ re@r$&.er d$+ re@r$&.er d$+ $&/io.e+/i$( $&/io.e+/i$( /e(8/e( /e(8/e( mo$rd mo$rd A Ki+idi+ A Ki+idi+ Do/i/ Do/i/ 2008500 m, 2008500 m, 58 &$(i 58 &$(i /e)$ri /e)$ri $rdio#i+ $rdio#i+ Kidi.$rd Kidi.$rd S#(@$/ S#(@$/ )i+idi+ )i+idi+ D$$. D$$. me+imb#(&$ me+imb#(&$ + )io.e+/i' + )io.e+/i' e+,(i)$.$+ e+,(i)$.$+ &$b#r' d$+ &$b#r' d$+ &e(#)$+ &e(#)$+ /$(#r$ er+$ /$(#r$ er+$ A A Di/oir$mid$ Di/oir$mid$ Do/i/ Do/i/  T

 To.$( )$ri$+o.$( )$ri$+ 008*00 m, 008*00 m,  T  Terb$,ierb$,i d$($m  d$($m  do/i/ do/i/ Nor$e Nor$e R.)mod$+ R.)mod$+ Gejala Gejala antikolinergik, antikolinergik, GI, gagal GI, gagal  jantung,  jantung, ventrikular ventrikular aritmia, aritmia, hipoglikemia hipoglikemia A A Pro&$i+$mid Pro&$i+$mid $ $ Do/i/ Do/i/  T

 Ter$i or$(er$i or$(  7$+,&$ ($m$  7$+,&$ ($m$ 58; ,)$ri 58; ,)$ri Pro+e/.( Pro+e/.( Gim$ Gim$ GI' $ri.mi$ GI' $ri.mi$ ve+.ri&#($r' ve+.ri&#($r' $,r$+#(o/i.o $,r$+#(o/i.o /i/ /i/

L$+7#.$+

L$+7#.$+

&. M"!/ &. M"!/ +!-*!*-""&!$ ""&!$ 6+" 6+" L-!-$ L-!-$ 8!/;!/ 8!/;!/ -$-""*-$ ""*-$ %!/ "!*! %!/ "!*! !/ !/ !$ !$ !*-/$*-!+ *+*+ !+ *+*+ "#! "#! 8A: 8A: L-!-$ L-!-$ D*-*: D*-*: 0,71,< 0,71,< "%4% BB "%4% BB *!! -=. *!! -=. L-%$!-$ L-%$!-$ L-$*/ L-$*/ >#+! >#+! >#+!-$ >#+!-$ SSP, SSP, *-*-* *-*-* A Mei(e.i+ A Mei(e.i+ Do/i/ Do/i/ 2008500 m, 2008500 m, diberi&$+ diberi&$+ .i$ * 7$m .i$ * 7$m Mei.e Mei.e Mei.i( Mei.i( SSP' SSP' /i&o/i/' GI' /i&o/i/' GI' $ri.mi$ $ri.mi$ ve+.ri&#($r ve+.ri&#($r ZA: Apridin

ZA: Apridin _{"ibor$+"ibor$+} ZA: Tocainide ZA: Tocainide Dosis: Dosis: 400-00 mg tiap 400-00 mg tiap ! jam" Dosis ! jam" Dosis tidak mele#ihi tidak mele#ihi $400 mg%hari" $400 mg%hari"  T  To+o$rdo+o$rd SSP'SSP' /i&o/i/' GI' /i&o/i/' GI' $ri.mi$ $ri.mi$ ve+.ri&#($r' ve+.ri&#($r' r#$m+eri r#$m+eri /e+di' /e+di' )e$.i.i/' )e$.i.i/' $,r$+#(o/i.o $,r$+#(o/i.o /i/ /i/

L$+7#.$+

L$+7#.$+

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DA"TAR PUSTAKA

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THAN6 YOU

THAN6 YOU