{"id":10055,"date":"2026-04-01T08:10:38","date_gmt":"2026-04-01T08:10:38","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10055"},"modified":"2026-04-01T08:10:39","modified_gmt":"2026-04-01T08:10:39","slug":"trace-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2\/","title":{"rendered":"Trac\u00e9 1.7: Bloc auriculo-ventriculaire du second degr\u00e9 type 2"},"content":{"rendered":"","protected":false},"featured_media":10054,"template":"","ecg_case_type":[250],"language_ecgcase":[259],"class_list":["post-10055","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 1.7: Bloc auriculo-ventriculaire du second degr\u00e9 type 2","patient_description":"Homme de 81 ans avec ant\u00e9c\u00e9dent d\u2019infarctus ant\u00e9rieur \u00e9tendu ancien; hospitalisation pour 2 \u00e9pisodes de syncope","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"l\u2019ECG montre un BAV du premier degr\u00e9","quiz_answer_2":"l\u2019ECG montre un BAV du second degr\u00e9 type Luciani-Wenckebach","quiz_answer_3":"l\u2019ECG montre un BAV du second degr\u00e9 type Mobitz 1","quiz_answer_4":"l\u2019ECG montre un BAV du second degr\u00e9 type Mobitz 2","quiz_answer_5":"l\u2019ECG montre une dysfonction sinusale","correct_answer":["D"],"ecg_image":10054,"ecg_description":"Activit\u00e9 sinusale r\u00e9guli\u00e8re; ondes P larges et bifides en DII, DIII et aVF, avec composante \u00e9largie n\u00e9gative en V1 (traduit une activation prolong\u00e9e de l\u2019oreillette gauche): aspect d\u2019hypertrophie auriculaire gauche; espace PR limite (200 ms); onde P bloqu\u00e9e sans modification de l\u2019espace PR (m\u00eame valeur avant et apr\u00e8s l\u2019onde P bloqu\u00e9e): aspect de BAV du second degr\u00e9 type 2 (Mobitz 2); QRS large (140 ms) avec aspect de bloc de branche droit et h\u00e9mibloc ant\u00e9rieur gauche (axe gauche); s\u00e9quelle de n\u00e9crose ant\u00e9rieure et inf\u00e9rieure (onde q dans les d\u00e9rivations correspondantes);","ecg_info_box":"Le BAV du second degr\u00e9 type 2 (Mobitz 2) correspond \u00e0 la survenue d\u2019une onde P bloqu\u00e9e sans modification pr\u00e9alable de l\u2019espace PR (PR constant avant et apr\u00e8s la pause). Il est la plupart du temps la cons\u00e9quence d\u2019une l\u00e9sion anatomique d\u00e9g\u00e9n\u00e9rative irr\u00e9versible situ\u00e9e dans la partie distale du faisceau de His ou dans une des trois branches, les 2 autres \u00e9tant d\u00e9j\u00e0 bloqu\u00e9es (bloc intra- ou infra-hisien).","commentary_ecg":"Le BAV du second degr\u00e9 type 2 (Mobitz 2) est beaucoup plus rare que le type 1; les ondes P bloqu\u00e9es non suivies de QRS surviennent inopin\u00e9ment, sans allongement pr\u00e9alable de l\u2019espace PR.\r\n\r\nL\u2019\u00e9lectrocardiogramme montre donc: \r\n\u2022 Un blocage intermittent de l\u2019onde P; la r\u00e9currence des ondes P bloqu\u00e9es peut \u00eatre r\u00e9guli\u00e8re mais est le plus souvent irr\u00e9guli\u00e8re; le nombre d\u2019ondes P bloqu\u00e9es est g\u00e9n\u00e9ralement major\u00e9 par les man\u0153uvres qui augmentent la fr\u00e9quence cardiaque (effort, atropine) et inversement pour les man\u0153uvres qui la diminuent. \r\n\u2022 L\u2019intervalle PR des complexes conduits est constant. \r\n\u2022 Les pauses ventriculaires sont de dur\u00e9e double de l\u2019intervalle RR normal. \r\n\u2022 Comme chez ce patient, les complexes ventriculaires sont le plus souvent anormaux; plus rarement une morphologie normale (QRS fin) est observ\u00e9e.\r\n\r\nCe type de BAV II type 2 est la plupart du temps la cons\u00e9quence d\u2019une l\u00e9sion anatomique d\u00e9g\u00e9n\u00e9rative irr\u00e9versible. L\u2019enregistrement des potentiels du faisceau de His montre que l\u2019origine du blocage intermittent se situe habituellement dans la partie distale du faisceau de His ou dans une des trois branches, les 2 autres \u00e9tant d\u00e9j\u00e0 bloqu\u00e9es (bloc intra- ou infra-hisien). Cela explique la constance de l\u2019espace PR avant et apr\u00e8s l\u2019onde P bloqu\u00e9e, la conduction se faisant selon le principe du tout ou rien.\r\n\r\nCe type de trac\u00e9 est une indication indiscutable de pose de stimulateur. En effet, la progression vers le BAV III est fr\u00e9quente; de plus, en raison de la localisation du bloc, les \u00e9chappements potentiels sont bas situ\u00e9s et sont souvent lents et instables majorant le risque de syncope ou de mort subite.\r\n","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrac\u00e9 1.7: Bloc auriculo-ventriculaire du second degr\u00e9 type 2 - 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-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 1.7: Bloc auriculo-ventriculaire du second degr\u00e9 type 2 - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-01T08:10:39+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-7-bloc-auriculo-ventriculaire-du-second-degre-type-2\/\",\"name\":\"Trac\u00e9 1.7: Bloc auriculo-ventriculaire du second degr\u00e9 type 2 - 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