{"id":10083,"date":"2026-04-01T11:32:02","date_gmt":"2026-04-01T11:32:02","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10083"},"modified":"2026-04-01T11:32:03","modified_gmt":"2026-04-01T11:32:03","slug":"trace-2-7-maladie-de-loreillette","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-2-7-maladie-de-loreillette\/","title":{"rendered":"Trac\u00e9 2.7: Maladie de l\u2019oreillette"},"content":{"rendered":"","protected":false},"featured_media":10082,"template":"","ecg_case_type":[251],"language_ecgcase":[259],"class_list":["post-10083","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-sinus-dysfunction","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 2.7: Maladie de l\u2019oreillette","patient_description":"Homme de 85 ans avec insuffisance mitrale grade II et ant\u00e9c\u00e9dents de fibrillation auriculai\u00ad re trait\u00e9e par anticoagulants et amiodarone; hospitalisation pour palpitations et majoration de troubles cognitifs","quiz_question":"Quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s) concernant la maladie de l\u2019oreillette? Elle associe typiquement:","quiz_answer_1":"un BAV paroxystique","quiz_answer_2":"une dysfonction sinusale","quiz_answer_3":"une arythmie supra-ventriculaire","quiz_answer_4":"une BAV permanent","quiz_answer_5":"un syndrome de Wolf Parkinson White","correct_answer":["B","C"],"ecg_image":10082,"ecg_description":"Tachycardie supra-ventriculaire avec conduction atrioventriculaire irr\u00e9guli\u00e8re; fr\u00e9quence ventriculaire \u00e0 95 battements\/minute; activit\u00e9 atriale rapide et r\u00e9guli\u00e8re correspondant \u00e0 une tachycardie atriale; bloc de branche droit complet (dur\u00e9e du QRS \u00e0 125 ms, aspect rSR\u2019 en V1, onde q septale et onde S \u00e9largie en V6); III II aVF","ecg_info_box":"La maladie de l\u2019oreillette traduit l\u2019existence d\u2019une alt\u00e9ration diffuse de l\u2019oreillette touchant le n\u0153ud sinusal (expliquant la bradycardie) et le myocarde auriculaire (expliquant les arythmies supra-ventriculaires).","commentary_ecg":"La maladie de l\u2019oreillette ou maladie rythmique auriculaire ou syndrome bradycardie- tachycardie se caract\u00e9rise par l\u2019alternance entre des \u00e9pisodes de tachycardie (tachycardie atriale, FA, flutter commun) et des \u00e9pisodes de bradycardie en rapport avec une dysfonction sinusale. La symptomatologie associe signes cliniques secondaires \u00e0 la tachycardie (palpitations, insuffisance cardiaque) et \u00e0 la bradycardie (fatigue, troubles cognitifs, dyspn\u00e9e, lipothymie, syncope). Cette association sugg\u00e8re des l\u00e9sions organiques diffuses avec atteinte d\u00e9g\u00e9n\u00e9rative des cellules automatiques du n\u0153ud sinusal mais \u00e9galement fibrose s\u2019\u00e9tendant au myocarde auriculaire et parfois au tissu sp\u00e9cifique de la jonction auriculo-ventriculaire expliquant l\u2019observation concomitante possible de troubles de la conduction auriculo-ventriculaire.\r\n\r\nIl est courant de diff\u00e9rencier maladie de l\u2019oreillette (absence de lien chronologique entre les acc\u00e8s de tachycardie et les acc\u00e8s de bradycardie), pauses post- r\u00e9ductionnelles (pauses sinusales observ\u00e9es exclusivement lors de la r\u00e9duction de l\u2019arythmie atriale) et arythmies vagales (\u00e9pisodes d\u2019arythmie observ\u00e9s uniquement \u00e0 la suite d\u2019un ralentissement sinusal d\u2019origine vagal).\r\n\r\n","ecg_info_post_answer":"\"\"\r\n\r\nDescription trac\u00e9<\/strong>\r\n\r\nBradycardie \u00e0 25 battements\/minute; rythme d\u2019\u00e9chappement auriculaire provenant du sinus coronaire (activit\u00e9 atriale n\u00e9gative dans les d\u00e9rivations inf\u00e9rieures, traduisant une activation provenant de la partie basse de l\u2019oreillette), QRS fin (aspect morphologique proche de celui du QRS en tachycardie mais plus fin);\r\n\r\n\"\""},"yoast_head":"\nTrac\u00e9 2.7: Maladie de l\u2019oreillette - 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