Những vấn đề cơ bản về điện tâm đồ

Những&vấn&đề&cơ&bản&về&&
Điện&Tim&Đồ&trong&&
thực&hành&lâm&sàng&
&
!"#$%#$&!'()&*(+'&,-+.&
%/01&23+&45+&./6+&'78&4/9+&:;)&4<&
•  *=+.&)>?+&.@&:A&B%BC&
•  D'E/&+/9)&'=(:&4F+.&4/9+&2G8&%H&25&I)&
•  ,@+'&J(+.&B%B&25&K6+&
•  LM)&:'0&+M=&.'/&)F:&B%BC&
•  %NO2&4/9+&I)C&
•  !';+&P2'&2E2&Q7+.&B%B&25&K6+&
•  RE2&KST2&25&K6+&4U2&VM&%N6&WX/&Y0:&Z>6&)F:&
B%B&
*=+.&2'X&.@&:A&B%BCC&
•  LM&1'S5+.&I9+&2'[+&4=E+&K\&:N]&^W;)&QM+.&VM&
23+&W;)&QM+.&Y'E2_`&Y'a+.&1'6/&WM&Z>b0:&4c+'&&
•  R7&./E&:Nc&2'[+&4=E+`&4c+'&'ST+.&4/d>&:Nc&:N=+.&
2E2&N?/&W=(+&+'c1&
•  "/e1&'f&:N]&2'[+&4=E+&+.>bg+&+';+&48>&+.h2i&
:'j=&Jk/&'/9>&Z>6&Q8>&Ig>&'>b0:&Y'?/&
•  ,f&:N]&2'[+&4=E+&Y'7&:'l&
•  mn&2o+&27&)F:&Q?&Z>b&:p2&4U2&B%B&2'=&45+&
./6+&'78&
R'q&4c+'&WM)&B%B&
•  %r:&26&K9+'&+';+&4s&4S]2&K/0:&K9+'&I)&)(2'&
•  %r:&26&K9+'&+';+&27&K/t>&'/9+&K9+'&I)&)(2'&
•  %r:&26&K9+'&+';+&+.>b&25&I)&)(2'&
•  %NST2&1'u>&:'>3:&
•  %'j=&Jk/&4/d>&:Nc&
•  D'E)&Qv2&Y'wj&l&+.SX/&:Ng+&xy&:>\/&

D'E/&+/9)&'=(:&4F+.&4/9+&'U2&2G8&I)&
•  R5&I)&'=(:&4F+.&J=&'/9+&:S]+.&:E/&Y'z&2h2&
2G8&:0&KM=&^:N8=&4\/&/=+&Z>8&)M+.&:0&KM=_&
•  B/9+&:'0&'=(:&4F+.&+Mb&27&:'t&.'/&2'{1&4S]2&
+'X&2E2&4/9+&2h2&4|:&:Ng+&Kd&)|:&25&:'t&^Y'/&
25&:N5+&:()&+.A+.&'=(:&4F+._&
•  %/)&27&x&K><+.i&4/9+&'U2&2'q&2'/8&}&:o+.&^+'~&•&
:'r:_&
,9&:'?+.&Ju+&:N>bd+&2G8&I)&
,9&:'?+.&Ju+&:N>bd+&2G8&I)&
€.>bg+&W•&25&K6+&.'/&‚R"&
H8ƒjNb&&
R5&:'t&WM&2'r:&Ju+&4/9+&:?:&
„&
B/9+&:;)&4<&WM&.@CCC&
! ĐTĐ&(ECG&–&Electrocardiogram):&
"'/&W(/&&K/t>&4<&'=(:&4F+.&4/9+&'U2&2G8&I)&:Ng+&)F:&
45+&Vc&:'X/&./8+$&
•  B/9+&:'0&'=(:&4F+.&%H&25&I)&4S]2&:N>bd+&Ju+&N8&:Ng+&Kd&
)|:&25&:'t&VM&2=&:'t&.'/&W(/&4S]2&:'a+.&Z>8&2E2&4/9+&2h2&
•  B%B&D,…€"&1'6/&WM&4=&4S]2&J†+.&)E>&^WS>&WS]+._&2'6b&
:N=+.&I)$&
&
! Máy&điện&Jm&đồ&(Electrocardiograph):&&WM&:'/0:&Kc&.'/&W(/&
4S]2&'=(:&4F+.&4/9+&'U2&2G8&I)&
‡&
RE2&1'8&'=(:&4F+.&2G8&%H&25&I)&VM&
K/t>&4<&4/9+&'U2&.'/&4S]2&
#5&4<&2E2&1'8&'=(:&4F+.&VM&'@+'&6+'&)F:&
K/t>&4<&'=(:&4F+.&4/9+&:'t&:0&KM=&25&I)&

B%B&.'/&W(/&4S]2&1'6+&E+'&:\+.&']1&
2G8&2E2&Vj2:=N&
B?/&2'/0>&'ST+.&1'6+&E+'&B%B&+'@+&
:A&2E2&1'ˆ8&
RE2&Vc&:Nˆ&4/9+&2h2&Y'E2&+'8>&Ju+&:T/&'@+'&JE+.&
B%B&Y'E2&+'8>&:'j=&:NO2&Vj2:=N&4/9+&'U2&
,@+'&JE+.&Q7+.&B%B&25&K6+&
,=(:&4F+.&Y'z&2h2&2G8&+'~&&^Q7+.&!_&VM&Ju+&
:N>b0+&‰>?+.&+e:&+'~Š:'r:&^B=(+&!‹_&
&Q7+.&!&VM&B=(+&!‹&
,=(:&4F+.&Y'z&2h2&2G8&:'r:&
!'v2&KF&Œ‹#&
%'X/&./8+&VM&:?2&4F&B%B&Z>b&ST2&
%o+&Q?&I)&m&•yyŽQ?&a&WT+&'=|2&••yyŽQ?&a&+'w&
B=&:'X/&./8+&!‹&
B=&4F&NF+.&1'v2&KF&Œ‹#&
RE2&Y'=6+.&^4=(+_&:Ng+&B%B&:'a+.&:'SX+.&&
! !‹&‘&y$•}&•&y$}y&Qj2&
! Œ‹#&‘&y$y„&•&y$•yQj2&
! Œ%&‘&y$xyŠy$x•Qj2&
! #%‘&&y$•}&Š&Qj2&
}•&
RE2'&.'/&B%B&•}&2'>bt+&4(=&
•  R'>[+&Kc&H€i&2'>[+&Kc&)Eb&.'/&
•  H€&+’)&+.z8`&:'S&./s+`&:NE+'&2=&25&
•  B|:&2E2&4/9+&2h2&:'j=&4e+.&:N@+'&:h‘&x&4/9+&2h>&
+.=(/&K/g+i&“&4/9+&2h2&:NST2&I)i&J;b&;)&^2'e&•&
V-+.&J8&JE+&4/9+&2h2&Q(2'&'=|2&27&2'r:&Ju+&4/9+&
:?:_&
•  R'>[+&'78&^28W/KN8:j_&&2SX+.&4F&•&)”&

•  "'/&“&2'>b0+&4(=&+.=(/&V/&:NST2i&“&2'>bt+&4(=&
:NST2&I)&Q8>&
•  "'/&:'g)&2E2&2'>bt+&4(=&Y'E2&:'j=&bg>&2o>&W;)&
QM+.&
€.>bg+&:p2&:8)&./E2&‚/+:'=Vj+&&
%NO2&2G8&2E2&2'>bt+&4(=&
2E2&2'/&'@+'&:8)&./E2&
+.S]2&K8=&Z>8+'&I)&
&
&
}•&