{"id":10061,"date":"2026-04-01T08:14:18","date_gmt":"2026-04-01T08:14:18","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10061"},"modified":"2026-04-08T16:36:45","modified_gmt":"2026-04-08T16:36:45","slug":"trace-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel\/","title":{"rendered":"Trac\u00e9 1.9: Syncope sur bloc auriculo-ventriculaire complet avec \u00e9chappement jonctionnel"},"content":{"rendered":"","protected":false},"featured_media":10060,"template":"","ecg_case_type":[250],"language_ecgcase":[259],"class_list":["post-10061","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 1.9: Syncope sur bloc auriculo-ventriculaire complet avec \u00e9chappement jonctionnel","patient_description":"Homme de 83 ans avec r\u00e9tr\u00e9cissement aortique serr\u00e9 en attente de chirurgie cardiaque; hospitalisation pour 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 2 Mobitz 2","quiz_answer_2":"l\u2019ECG montre un BAV type 2\/1","quiz_answer_3":"l\u2019ECG montre un BAV du troisi\u00e8me degr\u00e9","quiz_answer_4":"l\u2019ECG montre une tachycardie sinusale r\u00e9flexe","quiz_answer_5":"l\u2019ECG montre un \u00e9chappement jonctionnel","correct_answer":["C","D","E"],"ecg_image":10679,"ecg_description":"Aspect de BAV du troisi\u00e8me degr\u00e9: tachycardie sinusale (105 battements\/minute) avec bradycardie ventriculaire (40 battements\/minute); dissociation auriculo-ventriculaire; probable \u00e9chappement jonctionnel avec bloc de branche droit et h\u00e9mibloc ant\u00e9rieur gauche;","ecg_info_box":"Le diagnostic de BAV complet se d\u00e9finit par l\u2019interruption compl\u00e8te de la conduction auriculo-ventriculaire et repose sur l\u2019existence d\u2019une dissociation auriculo-ventriculaire. La fr\u00e9quence et la dur\u00e9e du QRS varient en fonction du site d\u2019\u00e9chappement. Il existe souvent une tachycardie sinusale r\u00e9flexe.","commentary_ecg":"Le diagnostic de BAV complet se d\u00e9finit par l\u2019interruption compl\u00e8te de la conduction auriculo-ventriculaire et repose sur l\u2019existence d\u2019une dissociation auriculo- ventriculaire, les oreillettes et les ventricules \u00e9tant sous le contr\u00f4le de pacemakers ind\u00e9pendants, avec une fr\u00e9quence ventriculaire plus lente que la fr\u00e9quence auriculaire. Il n\u2019existe pas de relation entre les ondes P et les complexes QRS, les intervalles PR sont variables sans s\u00e9quence r\u00e9p\u00e9titive.\r\n\r\nLa fr\u00e9quence de l\u2019\u00e9chappement ventriculaire est g\u00e9n\u00e9ralement r\u00e9guli\u00e8re, non ou peu influenc\u00e9e par les efforts ou les man\u0153uvres vagales. La fr\u00e9quence et la dur\u00e9e du QRS varient en fonction du site d\u2019\u00e9chappement: \r\n\u2022 \u00e9chappement jonctionnel: l\u2019origine de l\u2019\u00e9chappement \u00e9tant haut situ\u00e9e au dessus de la bifurcation du faisceau de His, la dur\u00e9e des complexes QRS est normale (inf\u00e9rieure \u00e0 100 ms) sauf si il existe un bloc de branche pr\u00e9existant (comme chez ce patient); la fr\u00e9quence ventriculaire est g\u00e9n\u00e9ralement mod\u00e9r\u00e9ment ralentie (entre 40 et 50 battements par minute); \r\n\u2022 \u00e9chappement du faisceau de His ou d\u2019une des branches: l\u2019origine de l\u2019\u00e9chappement \u00e9tant situ\u00e9e soit au niveau du faisceau de His, soit au-dessous de la bifurcation sur une des branches, le QRS peut \u00eatre fin (\u00e9chappement du His) ou large avec un aspect de boc de branche (His + bloc de branche ou \u00e9chappement d\u2019une branche); la fr\u00e9quence ventriculaire est g\u00e9n\u00e9ralement ralentie (entre 30 et 40 battements par minute); \r\n\u2022 \u00e9chappement ventriculaire: l\u2019origine de l\u2019\u00e9chappement \u00e9tant bas situ\u00e9e et correspondant \u00e0 un foyer idioventriculaire, la dur\u00e9e des complexes QRS est tr\u00e8s \u00e9largie (entre 140 et 200 ms) et ne rappelle que tr\u00e8s grossi\u00e8rement l\u2019aspect d\u2019un bloc de branche et est qualifi\u00e9e de retard droit ou de retard gauche; la fr\u00e9quence ventriculaire est tr\u00e8s ralentie (parfois inf\u00e9rieure \u00e0 20 battements par minute). \r\n\r\nLe rythme auriculaire est le plus souvent sinusal m\u00eame si on peut observer une fibrillation auriculaire ou un flutter atrial. Le rythme sinusal est parfois acc\u00e9l\u00e9r\u00e9, la fr\u00e9quence auriculaire ayant tendance \u00e0 \u00eatre d\u2019autant plus rapide que la fr\u00e9quence ventriculaire est lente par une r\u00e9action r\u00e9flexe du n\u0153ud sinusal \u00e0 la bradycardie ventriculaire.\r\n","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrac\u00e9 1.9: Syncope sur bloc auriculo-ventriculaire complet avec \u00e9chappement jonctionnel - 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-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 1.9: Syncope sur bloc auriculo-ventriculaire complet avec \u00e9chappement jonctionnel - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-08T16:36:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-1-9-ecg-3.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1423\" \/>\n\t<meta property=\"og:image:height\" content=\"1610\" \/>\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-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-1-9-syncope-sur-bloc-auriculo-ventriculaire-complet-avec-echappement-jonctionnel\/\",\"name\":\"Trac\u00e9 1.9: Syncope sur bloc auriculo-ventriculaire complet avec \u00e9chappement jonctionnel - 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