{"id":10118,"date":"2026-04-02T15:24:43","date_gmt":"2026-04-02T15:24:43","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10118"},"modified":"2026-04-09T09:45:09","modified_gmt":"2026-04-09T09:45:09","slug":"trace-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire\/","title":{"rendered":"Trac\u00e9 4.4: R\u00e9duction du pourcentage de stimulation ventriculaire"},"content":{"rendered":"","protected":false},"featured_media":10117,"template":"","ecg_case_type":[253],"language_ecgcase":[259],"class_list":["post-10118","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 4.4: R\u00e9duction du pourcentage de stimulation ventriculaire","patient_description":"M\u00eame patient que trac\u00e9 pr\u00e9c\u00e9dent; programmation en mode DDD 70 bpm puis en mode MVP (Managed Ventricular Pacing).","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"les oreillettes sont stimul\u00e9es tout au long du trac\u00e9","quiz_answer_2":"les oreillettes sont initialement stimul\u00e9es puis d\u00e9tect\u00e9es","quiz_answer_3":"les ventricules sont stimul\u00e9s tout au long du trac\u00e9","quiz_answer_4":"les ventricules sont initialement stimul\u00e9s puis d\u00e9tect\u00e9s","quiz_answer_5":"il existe un bloc auriculo-ventriculaire complet permanent","correct_answer":["A","D"],"ecg_image":10117,"ecg_description":"Initialement, le stimulateur est programm\u00e9 en mode DDD avec un trac\u00e9 identique au pr\u00e9c\u00e9dent; en fin de trac\u00e9, programmation du mode MVP et reprise d\u2019une conduction atrio-ventriculaire spontan\u00e9e (stimulation atriale et d\u00e9tection ventriculaire);","ecg_info_box":"Les diff\u00e9rents constructeurs ont d\u00e9velopp\u00e9 un mode de stimulation sp\u00e9cifique pour diminuer le pourcentage de stimulation ventriculaire droite inutile chez les patients non d\u00e9pendants. Le fonctionnement particulier de chaque constructeur doit \u00eatre connu par le m\u00e9decin pour pouvoir interpr\u00e9ter les sp\u00e9cificit\u00e9s de chaque trac\u00e9. ","commentary_ecg":"Il existe une litt\u00e9rature riche permettant de d\u00e9montrer l\u2019effet d\u00e9l\u00e9t\u00e8re d\u2019une stimulation ventriculaire droite prolong\u00e9e. De m\u00eame, toute r\u00e9duction de stimulation ventriculaire inutile permet d\u2019\u00e9conomiser les batteries et d\u2019optimiser la dur\u00e9e de vie du stimulateur. Diff\u00e9rents modes ont \u00e9t\u00e9 propos\u00e9s par les constructeurs (MVP pour les stimulateurs Medtronic) pour r\u00e9duire le pourcentage de stimulation ventriculaire sans compromettre la s\u00e9curit\u00e9 du patient lors de la survenue d\u2019un trouble de conduction auriculo-ventriculaire. L\u2019indication privil\u00e9gi\u00e9e de ce type de mode est donc l\u2019existence d\u2019une dysfonction sinusale avec conduction auriculo-ventriculaire pr\u00e9serv\u00e9e ou alt\u00e9r\u00e9e de fa\u00e7on paroxystique.\r\n\r\nLe mode MVP, AAI<=>DDD, permet une stimulation en mode ADI tout en surveillant la conduction auriculo-ventriculaire. Le fonctionnement de cet algorithme est relativement simple avec un seul crit\u00e8re de commutation vers le mode DDD. Au cours du fonctionnement en mode ADI, les param\u00e8tres associ\u00e9s avec la stimulation atriale simple chambre sont applicables. La d\u00e9tection ventriculaire est active.\r\n\r\nSur ce trac\u00e9, l\u2019avantage majeur de cet algorithme parait \u00e9vident. En effet, par rapport \u00e0 une stimulation en mode DDD, la programmation de ce mode permet de r\u00e9duire consid\u00e9rablement le pourcentage de stimulation. Sur le long terme, cela devrait s\u2019associer \u00e0 un b\u00e9n\u00e9fice en termes de remodelage ventriculaire et de survenue d\u2019arythmie atriale. L\u2019analyse du pourcentage de stimulation ventriculaire est donc un \u00e9l\u00e9ment important du suivi chez un patient avec dysfonction sinusale, de fa\u00e7on \u00e0 essayer de r\u00e9duire au maximum la survenue de toute stimulation ventriculaire inutile. ","ecg_info_post_answer":"\"\"\r\n\r\nDescription trac\u00e9<\/strong>\r\n\r\nL\u2019EGM confirme la reprise de la conduction spontan\u00e9e apr\u00e8s programmation du mode MVP (programmation r\u00e9ussie);"},"yoast_head":"\nTrac\u00e9 4.4: R\u00e9duction du pourcentage de stimulation ventriculaire - 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-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 4.4: R\u00e9duction du pourcentage de stimulation ventriculaire - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T09:45:09+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-4-ecg-6-scaled-e1775143300268.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1549\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\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-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-4-reduction-du-pourcentage-de-stimulation-ventriculaire\/\",\"name\":\"Trac\u00e9 4.4: R\u00e9duction du pourcentage de stimulation ventriculaire - 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