{"id":10063,"date":"2026-04-01T08:16:47","date_gmt":"2026-04-01T08:16:47","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10063"},"modified":"2026-04-01T08:16:49","modified_gmt":"2026-04-01T08:16:49","slug":"trace-1-10-bloc-auriculo-ventriculaire-complet-et-echappement-intermittent","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-1-10-bloc-auriculo-ventriculaire-complet-et-echappement-intermittent\/","title":{"rendered":"Trac\u00e9 1.10: Bloc auriculo-ventriculaire complet et \u00e9chappement intermittent"},"content":{"rendered":"","protected":false},"featured_media":10062,"template":"","ecg_case_type":[250],"language_ecgcase":[259],"class_list":["post-10063","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 1.10: Bloc auriculo-ventriculaire complet et \u00e9chappement intermittent","patient_description":"Homme de 54 ans sans ant\u00e9c\u00e9dent; hospitalisation pour syncope","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"l\u2019activit\u00e9 atriale est sinusale","quiz_answer_2":"il existe une tachycardie sinusale","quiz_answer_3":"il existe un BAV du second degr\u00e9 type 1","quiz_answer_4":"il existe un BAV du second degr\u00e9 type 2","quiz_answer_5":"il existe un BAV du troisi\u00e8me degr\u00e9","correct_answer":["A","B","E"],"ecg_image":10062,"ecg_description":"BAV du troisi\u00e8me degr\u00e9 avec dissociation auriculo-ventriculaire (tachycardie sinusale \u00e0 100 battements par minute); \u00e9chappement jonctionnel intermittent avec QRS fin et h\u00e9mibloc ant\u00e9rieur gauche (QRS fin, onde q en DI, aVL, et grande onde S en DII, DIII, aVF, axe gauche); en l\u2019absence d\u2019\u00e9chappement jonctionnel, \u00e9chappement ventriculaire plus bas situ\u00e9 (QRS large, axe droit) associ\u00e9 avec une baisse de la fr\u00e9quence cardiaque (espace RR plus long quand \u00e9chappement ventriculaire que quand \u00e9chappement jonctionnel)","ecg_info_box":"Plus le bloc auriculo-ventriculaire est bas situ\u00e9, plus grand est le risque que l\u2019\u00e9chappement soit lent, fragile et intermittent ce qui explique le risque accru de syncope ou de mort subite. ","commentary_ecg":"Le rythme jonctionnel ou ventriculaire d\u2019\u00e9chappement chez un patient en BAV III est g\u00e9n\u00e9ralement r\u00e9gulier, l\u2019\u00e9lectrocardiogramme montrant la dissociation atrio- ventriculaire et la pr\u00e9sence d\u2019une bradycardie ventriculaire r\u00e9guli\u00e8re avec des complexes QRS monomorphes. Parfois, l\u2019\u00e9chappement peut \u00eatre instable, son activit\u00e9 se ralentissant ou s\u2019interrompant brutalement, ce qui occasionne la survenue de sympt\u00f4mes plus ou moins graves en fonction de la dur\u00e9e de la pause et pouvant aller jusqu\u2019\u00e0 la mort subite. Ce trac\u00e9 montre le caract\u00e8re labile de l\u2019\u00e9chappement jonctionnel de ce patient. Quand il est pr\u00e9sent, le QRS est relativement fin, la fr\u00e9quence est lente mais permet toutefois d\u2019assurer une h\u00e9modynamique correcte. Quand cet \u00e9chappement ne s\u2019exprime plus, un second foyer d\u2019\u00e9chappement ventriculaire plus bas situ\u00e9 prend le relais avec des QRS larges et une fr\u00e9quence plus lente occasionnant la survenue de sympt\u00f4mes et sugg\u00e9rant un risque majeur de mort subite.\r\n\r\nCe patient a b\u00e9n\u00e9fici\u00e9 de la pose d\u2019un stimulateur cardiaque en urgence.","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrac\u00e9 1.10: Bloc auriculo-ventriculaire complet et \u00e9chappement intermittent - 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-1-10-bloc-auriculo-ventriculaire-complet-et-echappement-intermittent\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 1.10: Bloc auriculo-ventriculaire complet et \u00e9chappement intermittent - 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