{"id":10115,"date":"2026-04-02T15:21:28","date_gmt":"2026-04-02T15:21:28","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10115"},"modified":"2026-04-02T15:21:29","modified_gmt":"2026-04-02T15:21:29","slug":"trace-4-3-mode-ddd","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-3-mode-ddd\/","title":{"rendered":"Trac\u00e9 4.3: Mode DDD"},"content":{"rendered":"","protected":false},"featured_media":10114,"template":"","ecg_case_type":[253],"language_ecgcase":[259],"class_list":["post-10115","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-cardiac-pacing","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 4.3: Mode ddd","patient_description":"M\u00eame patient que trac\u00e9 pr\u00e9c\u00e9dent; programmation en mode DDD 70 bpm","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"l\u2019activit\u00e9 atriale est spontan\u00e9e","quiz_answer_2":"l\u2019activit\u00e9 atriale est stimul\u00e9e en bipolaire","quiz_answer_3":"l\u2019activit\u00e9 ventriculaire est spontan\u00e9e","quiz_answer_4":"l\u2019activit\u00e9 ventriculaire est stimul\u00e9e en unipolaire","quiz_answer_5":"l\u2019activit\u00e9 ventriculaire est stimul\u00e9e en bipolaire","correct_answer":["D"],"ecg_image":10114,"ecg_description":"Stimulation unipolaire atriale (stimuli de grande amplitude) et stimulation unipolaire ventriculaire apr\u00e8s un d\u00e9lai atrio-ventriculaire fixe;","ecg_info_box":"Le mode DDD est sens\u00e9 r\u00e9pondre aux caract\u00e9ristiques pr\u00e9sent\u00e9es par l\u2019ensemble des patients implant\u00e9s mais peut \u00eatre associ\u00e9 avec un pourcentage \u00e9lev\u00e9 de stimulation ventriculaire d\u00e9l\u00e9t\u00e8re chez des patients pr\u00e9sentant une conduction atrio-ventriculaire pr\u00e9serv\u00e9e. \r\n\r\n","commentary_ecg":"Le mode DDD correspond au mode de programmation standard des stimulateurs double chambre ou de resynchronisation. Il permet d\u2019assurer une synchronisation auriculo-ventriculaire au repos comme \u00e0 l\u2019effort sur activit\u00e9 atriale d\u00e9tect\u00e9e ou stimul\u00e9e. En effet, le principe de base du mode DDD est de synchroniser la stimulation ventriculaire sur la d\u00e9tection (fonctionnement d\u00e9clench\u00e9) ou la stimulation atriale. Une activit\u00e9 atriale ou ventriculaire spontan\u00e9e d\u00e9tect\u00e9e hors p\u00e9riode r\u00e9fractaire inhibe respectivement la stimulation atriale ou ventriculaire (fonctionnement inhib\u00e9). Ce mode permet donc de pr\u00e9server un synchronisme atrio-ventriculaire pour des fr\u00e9quences sinusales basses jusqu\u2019\u00e0 des fr\u00e9quences \u00e9lev\u00e9es (limite de la fr\u00e9quence maximale). Toute d\u00e9tection atriale en dehors de la p\u00e9riode r\u00e9fractaire entre fr\u00e9quence de base et fr\u00e9quence maximale synchrone ou stimulation atriale entraine un d\u00e9lai AV avec stimulation ventriculaire en l\u2019absence de d\u00e9tection ventriculaire spontan\u00e9e. Les d\u00e9lais AV qui suivent les \u00e9v\u00e9nements atriaux d\u00e9tect\u00e9s et les \u00e9v\u00e9nements atriaux stimul\u00e9s sont programmables s\u00e9par\u00e9ment; il est possible de programmer le raccourcissement des d\u00e9lais AV lorsque les fr\u00e9quences augmentent (d\u00e9lai AV adaptable) ou leur modification en fonction des temps de conduction spontan\u00e9s. \r\n\r\nEn mode DDDR, le stimulateur suit la plus rapide des fr\u00e9quences, atriale intrins\u00e8que ou la fr\u00e9quence indiqu\u00e9e par le capteur. La fr\u00e9quence maximale synchrone et la fr\u00e9quence maximale asservie sont programmables s\u00e9par\u00e9ment. \r\n\r\nLa programmation du mode DDD semble donc satisfaisante chez ce patient. Cependant, le suivi permettrait probablement de mettre en \u00e9vidence un pourcentage de stimulation ventriculaire proche des 100%. Cela correspondrait donc \u00e0 un fonctionnement jug\u00e9 normal et appropri\u00e9. L\u2019analyse en 0D0 a toutefois r\u00e9v\u00e9l\u00e9 que ce patient pr\u00e9sente une conduction AV correcte. Une des priorit\u00e9s dea la programmation d\u2019un stimulateur est d\u2019\u00e9viter toute stimulation ventriculaire droite inutile. \r\n\r\nCela permet de r\u00e9duire la consommation de la batterie et de prolonger la dur\u00e9e de vie de l\u2019appareil et surtout, d\u2019\u00e9viter une stimulation ventriculaire droite qui est associ\u00e9e \u00e0 court, moyen et long termes avec des effets n\u00e9fastes sur le plan h\u00e9modynamique, sur le remodelage ventriculaire et sur la survenue d\u2019arythmies atriales. En effet, une stimulation ventriculaire droite induit une s\u00e9quence d\u2019activation et de relaxation inter-ventriculaire et intra-ventriculaire asynchrone. \r\n\r\nUn pourcentage \u00e9lev\u00e9 de stimulation ventriculaire chez un patient pr\u00e9sentant une conduction AV pr\u00e9serv\u00e9e doit interpeller le m\u00e9decin au moment de l\u2019interrogation et faire discuter de l\u2019utilisation d\u2019algorithmes sp\u00e9cifiques favorisant la conduction spontan\u00e9e. \r\n","ecg_info_post_answer":"<img class=\"alignnone wp-image-10414 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-3-ecg2.png\" alt=\"\" width=\"882\" height=\"757\" \/>\r\n\r\n<strong>Description trac\u00e9<\/strong>\r\n\r\nR\u00e9p\u00e9tition cycles AP-VP (stimulation atriale et ventriculaire) \u00e0 70 bpm;"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 4.3: Mode DDD - 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-4-3-mode-ddd\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 4.3: Mode DDD - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-3-mode-ddd\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-02T15:21:29+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-4-3-mode-ddd\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/\",\"name\":\"Trac\u00e9 4.3: Mode DDD - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-3-ecg-2-scaled-e1775143071252.jpeg\",\"datePublished\":\"2026-04-02T15:21:28+00:00\",\"dateModified\":\"2026-04-02T15:21:29+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-3-ecg-2-scaled-e1775143071252.jpeg\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-3-ecg-2-scaled-e1775143071252.jpeg\",\"width\":2560,\"height\":1694},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-3-mode-ddd\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 4.3: Mode DDD\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cardiocases.com\/#website\",\"url\":\"https:\/\/cardiocases.com\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; 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