{"id":10120,"date":"2026-04-02T15:26:58","date_gmt":"2026-04-02T15:26:58","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10120"},"modified":"2026-04-09T09:45:48","modified_gmt":"2026-04-09T09:45:48","slug":"trace-4-5-mvp-et-bloc-auriculo-ventriculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/","title":{"rendered":"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire"},"content":{"rendered":"","protected":false},"featured_media":10119,"template":"","ecg_case_type":[253],"language_ecgcase":[259],"class_list":["post-10120","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 4.5: Mvp et bloc auriculo-ventriculaire","patient_description":"Homme de 67 ans, implant\u00e9 d\u2019un stimulateur cardiaque double chambre pour bloc auricu\u00ad lo-ventriculaire complet ; enregistrement de ce trac\u00e9 lors de la consultation","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"il s\u2019agit d\u2019un stimulateur double chambre Boston Scientific","quiz_answer_2":"il s\u2019agit d\u2019un stimulateur double chambre St. Jude Medical","quiz_answer_3":"il s\u2019agit d\u2019un stimulateur double chambre Medtronic","quiz_answer_4":"il s\u2019agit d\u2019un stimulateur double chambre Biotronik","quiz_answer_5":"il s\u2019agit d\u2019un stimulateur double chambre Sorin","correct_answer":["C"],"ecg_image":10119,"ecg_description":"Initialement, stimulation atriale et stimulation ventriculaire (mode DDD); programmation du mode MVP (mode sp\u00e9cifique des dispositifs Medtronic); stimulation atriale non suivie d\u2019un QRS spontan\u00e9; sur le cycle suivant, stimulation atriale et stimulation ventriculaire avec un d\u00e9lai AV court (80 ms); ce d\u00e9lai AV court sur le cycle suivant l\u2019onde P bloqu\u00e9e est la signature du mode MVP; s\u00e9quence identique (stimulation atriale bloqu\u00e9e, stimulation atriale et stimulation ventriculaire avec d\u00e9lai AV court); retour au mode DDD avec d\u00e9lai AV programm\u00e9 (commutation quand 2 activit\u00e9s atriales sur 4 sont bloqu\u00e9es);","ecg_info_box":"Chaque constructeur propose un mode sp\u00e9cifique pour r\u00e9duire le pourcentage de stimulation ventriculaire, chacun avec ses sp\u00e9cificit\u00e9s. Une onde P bloqu\u00e9e peut correspondre \u00e0 un fonctionnement normal pour les stimulateurs double chambre Medtronic, Biotronik, Boston Scientific et Sorin mais pas pour les dispositifs St. Jude Medical. ","commentary_ecg":"Ce trac\u00e9 permet de voir les sp\u00e9cificit\u00e9s du mode MVP pour les stimulateurs Medtronic. Il est essentiel d\u2019en comprendre les bases de fonctionnement de fa\u00e7on \u00e0 ne pas \u00eatre surpris par l\u2019existence d\u2019ondes P bloqu\u00e9es qui pourraient sugg\u00e9rer un dysfonctionnement. Il n\u2019est pas rare d\u2019\u00eatre appel\u00e9 par une infirmi\u00e8re consid\u00e9rent un trac\u00e9 avec onde P bloqu\u00e9e comme anormal.\r\n\r\nPour le mode MVP, si une seule activit\u00e9 atriale (d\u00e9tect\u00e9e hors p\u00e9riode r\u00e9fractaire ou stimul\u00e9e) est bloqu\u00e9e, le dispositif reste en mode ADI et fournit une impulsion de stimulation ventriculaire de secours 80 ms apr\u00e8s l\u2019activit\u00e9 atriale (d\u00e9tect\u00e9e hors p\u00e9riode r\u00e9fractaire ou stimul\u00e9e) suivante. Une seule onde P bloqu\u00e9e n\u2019induit donc pas de commutation. En revanche, si 2 activit\u00e9s atriales (d\u00e9tect\u00e9es hors p\u00e9riode r\u00e9fractaire ou stimul\u00e9es) sur 4 sont bloqu\u00e9es, le dispositif commute en mode DDD. Une stimulation ventriculaire de s\u00e9curit\u00e9 est d\u00e9livr\u00e9e 80 ms apr\u00e8s chaque activit\u00e9 atriale suivant le cycle d\u00e9ficitaire. Il ne peut donc pas y avoir 2 activit\u00e9s atriales bloqu\u00e9es cons\u00e9cutives. La dur\u00e9e de la pause ventriculaire maximale d\u00e9pend de la fr\u00e9quence sinusale et de la fr\u00e9quence minimale programm\u00e9e (pause maximale plus ou moins \u00e9gale \u00e0 la moiti\u00e9 de la fr\u00e9quence minimale programm\u00e9e). Il existe donc un seul crit\u00e8re de commutation (pas de commutation sur PR long par exemple).\r\n\r\nApr\u00e8s avoir commut\u00e9 en mode DDD, le dispositif contr\u00f4le r\u00e9guli\u00e8rement la conduction AV dans l\u2019attente de revenir au mode ADI. La premi\u00e8re v\u00e9rification de la conduction AV survient 1 minute apr\u00e8s la commutation en mode DDD. Au cours de cette v\u00e9rification, le dispositif passe en mode de stimulation ADI pendant un cycle. Si l\u2019intervalle A-A suivant comprend un battement ventriculaire d\u00e9tect\u00e9, le contr\u00f4le de la d\u00e9tection a r\u00e9ussi. Le dispositif reste en mode de stimulation ADI. Si l\u2019intervalle A-A suivant n\u2019inclut pas de battement ventriculaire d\u00e9tect\u00e9 (possibilit\u00e9 d\u2019une onde P bloqu\u00e9e), le contr\u00f4le de la conduction a \u00e9chou\u00e9 et le dispositif repasse en mode DDD. L\u2019intervalle s\u00e9parant chaque contr\u00f4le de la conduction est alors doubl\u00e9 (2, 4, 8...minutes jusqu\u2019\u00e0 un maximum de 16 heures). Si le patient est en bloc auriculo-ventriculaire complet, le dispositif fonctionne en mode DDD de mani\u00e8re persistante. Toutes les 16 heures, le dispositif v\u00e9rifie la pr\u00e9sence de conduction AV, ce qui r\u00e9sulte en un battement d\u00e9ficitaire. Tous les param\u00e8tres associ\u00e9s au mode DDD s\u2019appliquent.\r\n\r\n","ecg_info_post_answer":"<img class=\"alignnone wp-image-10416 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-5-ecg2.png\" alt=\"\" width=\"883\" height=\"774\" \/>\r\n\r\n<strong>Description trac\u00e9<\/strong>\r\n\r\nConfirmation sur les EGMs avec initialement mode DDD puis programmation du mode MVP (programmation r\u00e9ussie); les intervalles permettent de voir les d\u00e9lais AV: apr\u00e8s une stimulation atriale bloqu\u00e9e, d\u00e9lai AV \u00e0 80 ms sur le cycle suivant;"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 4.5: Mvp et bloc auriculo-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-4-5-mvp-et-bloc-auriculo-ventriculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T09:45:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1532\" \/>\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-4-5-mvp-et-bloc-auriculo-ventriculaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/\",\"name\":\"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg\",\"datePublished\":\"2026-04-02T15:26:58+00:00\",\"dateModified\":\"2026-04-09T09:45:48+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg\",\"width\":2560,\"height\":1532},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/cardiocases.com\/#website\",\"url\":\"https:\/\/cardiocases.com\/\",\"name\":\"Cardiocases\",\"description\":\"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists\",\"publisher\":{\"@id\":\"https:\/\/cardiocases.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/cardiocases.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/cardiocases.com\/#organization\",\"name\":\"Cardiocases\",\"url\":\"https:\/\/cardiocases.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png\",\"width\":1755,\"height\":499,\"caption\":\"Cardiocases\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.linkedin.com\/company\/cardiocases\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire - Cardiocases","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/","og_locale":"fr_FR","og_type":"article","og_title":"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire - Cardiocases","og_url":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/","og_site_name":"Cardiocases","article_modified_time":"2026-04-09T09:45:48+00:00","og_image":[{"width":2560,"height":1532,"url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Dur\u00e9e de lecture estim\u00e9e":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/","url":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/","name":"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire - Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage"},"thumbnailUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg","datePublished":"2026-04-02T15:26:58+00:00","dateModified":"2026-04-09T09:45:48+00:00","breadcrumb":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#primaryimage","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-5-ecg-4-scaled-e1775143494688.jpeg","width":2560,"height":1532},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-5-mvp-et-bloc-auriculo-ventriculaire\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Trac\u00e9 4.5: Mvp et bloc auriculo-ventriculaire"}]},{"@type":"WebSite","@id":"https:\/\/cardiocases.com\/#website","url":"https:\/\/cardiocases.com\/","name":"Cardiocases","description":"Real cardiac device traces, pacemaker &amp; ICD learning \u2014 built by electrophysiologists","publisher":{"@id":"https:\/\/cardiocases.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/cardiocases.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/cardiocases.com\/#organization","name":"Cardiocases","url":"https:\/\/cardiocases.com\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/07\/cardiocases_logo.png","width":1755,"height":499,"caption":"Cardiocases"},"image":{"@id":"https:\/\/cardiocases.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.linkedin.com\/company\/cardiocases\/"]}]}},"_links":{"self":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case\/10120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case"}],"about":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/types\/ecg_case"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media\/10119"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=10120"}],"wp:term":[{"taxonomy":"ecg_case_type","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case_type?post=10120"},{"taxonomy":"language_ecgcase","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/language_ecgcase?post=10120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}