{"id":10047,"date":"2026-04-01T07:20:07","date_gmt":"2026-04-01T07:20:07","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10047"},"modified":"2026-04-09T07:24:49","modified_gmt":"2026-04-09T07:24:49","slug":"trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/","title":{"rendered":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d"},"content":{"rendered":"","protected":false},"featured_media":10046,"template":"","ecg_case_type":[250],"language_ecgcase":[259],"class_list":["post-10047","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-atrioventricular-block","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d","patient_description":"Homme de 77 ans avec myocardiopathie dilat\u00e9e, hospitalis\u00e9 pour syncope","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"le rythme est sinusal","quiz_answer_2":"il existe une hypertrophie auriculaire gauche","quiz_answer_3":"il existe un bloc de branche droit","quiz_answer_4":"il existe un BAV du premier degr\u00e9","quiz_answer_5":"il existe un h\u00e9mibloc ant\u00e9rieur gauche","correct_answer":["A","B","C","D","E"],"ecg_image":10046,"ecg_description":"Rythme sinusal (ondes P positives en DI, DII, V5, V6, n\u00e9gatives en aVR); hypertrophie auriculaire gauche (onde P large, bifide avec composante n\u00e9gative large en V1); espace PR allong\u00e9 (220 ms) et fixe: BAV du premier degr\u00e9; QRS large (160 ms) avec aspect de bloc de branche droit (onde R de grande amplitude en V1, onde S large en V6) et h\u00e9mibloc ant\u00e9rieur gauche (axe gauche, aspect rS dans les d\u00e9rivations inf\u00e9rieures)","ecg_info_box":"Une association bloc bifasciculaire (bloc de branche droit + h\u00e9mibloc ant\u00e9rieur gauche) et PR allong\u00e9 ne traduit pas forc\u00e9ment l\u2019existence d\u2019un bloc trifasciculaire. La d\u00e9monstration d\u2019un intervalle HV long durant l\u2019exploration \u00e9lectrophysiologique d\u00e9montre le retard dans le fascicule restant.","commentary_ecg":"Cet \u00e9lectrocardiogramme montre un aspect de bloc bifasciculaire (bloc de branche droit + h\u00e9mibloc ant\u00e9rieur gauche) et un PR mod\u00e9r\u00e9ment allong\u00e9. Cette association est parfois \u00e0 tort consid\u00e9r\u00e9e comme un bloc trifasciculaire. En effet, cet \u00e9lectrocardiogramme ne permet pas isol\u00e9ment d\u2019affirmer l\u2019existence d\u2019un boc trifasciculaire, puisque le PR long peut \u00eatre le r\u00e9sultat d\u2019un ralentissement dans le n\u0153ud auriculo-ventriculaire (bloc bifasciculaire) et non pas dans l\u2019h\u00e9mibranche post\u00e9rieure gauche, le fascicule restant. Il ne s\u2019agit pas uniquement d\u2019un probl\u00e8me de s\u00e9mantique, puisque le pronostic diff\u00e8re en fonction du degr\u00e9 d\u2019extension des troubles conductifs. Une exploration \u00e9lectrophysiologique permet de d\u00e9finir le site du ralentissement expliquant l\u2019allongement de l\u2019intervalle PR en diff\u00e9renciant retard dans l\u2019oreillette ou le n\u0153ud auriculo-ventriculaire (intervalle AH allong\u00e9), retard dans le faisceau de His (potentiel hisien allong\u00e9 ou d\u00e9doubl\u00e9) et retard distal dans les branches et le r\u00e9seau de Purkinje (intervalle HV allong\u00e9). On retrouvait chez ce patient un intervalle HV pathologique \u00e0 90 ms, t\u00e9moin d\u2019une alt\u00e9ration de la conduction dans l\u2019h\u00e9mibranche \u201cfonctionnelle\u201d confirmant l\u2019existence d\u2019un bloc trifasciculaire \r\n\r\nCertaines anomalies \u00e9lectrocardiographiques d\u00e9montrent l\u2019existence d\u2019un bloc trifasciculaire sans n\u00e9cessit\u00e9 de confirmation par une exploration \u00e9lectrophysiologique: alternance entre bloc de branche gauche et bloc de branche droit, alternance entre bloc de branche droit\/h\u00e9mibloc ant\u00e9rieur gauche et bloc de branche droit\/h\u00e9mibloc post\u00e9rieur gauche.\r\n\r\nChez ce patient, la probabilit\u00e9 d\u2019un bloc auriculo-ventriculaire complet responsable de la syncope \u00e9tait tr\u00e8s \u00e9lev\u00e9e justifiant de l\u2019implantation d\u2019un stimulateur cardiaque.","ecg_info_post_answer":"<img class=\"alignnone wp-image-10286 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/page-017-1024x522.png\" alt=\"\" width=\"800\" height=\"408\" \/>"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T07:24:49+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1263\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/\",\"name\":\"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png\",\"datePublished\":\"2026-04-01T07:20:07+00:00\",\"dateModified\":\"2026-04-09T07:24:49+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png\",\"width\":2560,\"height\":1263},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cardiocases.com\/#website\",\"url\":\"https:\/\/cardiocases.com\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists\",\"publisher\":{\"@id\":\"https:\/\/cardiocases.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/cardiocases.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/cardiocases.com\/#organization\",\"name\":\"Cardiocases\",\"url\":\"https:\/\/cardiocases.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"width\":1755,\"height\":499,\"caption\":\"Cardiocases\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.linkedin.com\/company\/cardiocases\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/","og_locale":"fr_FR","og_type":"article","og_title":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases","og_url":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/","og_site_name":"Cardiocases","article_modified_time":"2026-04-09T07:24:49+00:00","og_image":[{"width":2560,"height":1263,"url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png","type":"image\/png"}],"twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/","url":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/","name":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d - Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage"},"thumbnailUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png","datePublished":"2026-04-01T07:20:07+00:00","dateModified":"2026-04-09T07:24:49+00:00","breadcrumb":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#primaryimage","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-3-ecg-5-scaled.png","width":2560,"height":1263},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-1-3-bloc-auriculo-ventriculaire-du-premier-degre-et-bloc-dit-trifasciculaire\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Trac\u00e9 1.3: Bloc auriculo-ventriculaire du premier degr\u00e9 et bloc dit \u201ctrifasciculaire\u201d"}]},{"@type":"WebSite","@id":"https:\/\/cardiocases.com\/#website","url":"https:\/\/cardiocases.com\/","name":"Cardiocases","description":"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists","publisher":{"@id":"https:\/\/cardiocases.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cardiocases.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cardiocases.com\/#organization","name":"Cardiocases","url":"https:\/\/cardiocases.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","width":1755,"height":499,"caption":"Cardiocases"},"image":{"@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cardiocases\/"]}]}},"_links":{"self":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case\/10047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case"}],"about":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/types\/ecg_case"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media\/10046"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=10047"}],"wp:term":[{"taxonomy":"ecg_case_type","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case_type?post=10047"},{"taxonomy":"language_ecgcase","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/language_ecgcase?post=10047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}