{"id":10125,"date":"2026-04-02T15:37:54","date_gmt":"2026-04-02T15:37:54","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&#038;p=10125"},"modified":"2026-04-09T09:47:43","modified_gmt":"2026-04-09T09:47:43","slug":"trace-4-7-perte-de-capture-ventriculaire","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/","title":{"rendered":"Trac\u00e9 4.7: Perte de capture ventriculaire"},"content":{"rendered":"","protected":false},"featured_media":10124,"template":"","ecg_case_type":[253],"language_ecgcase":[259],"class_list":["post-10125","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 4.7: Perte de capture ventriculaire","patient_description":"Homme de 78 ans, implant\u00e9 d\u2019un stimulateur double chambre dans le cadre d\u2019un bloc auriculo-ventriculaire complet avec sonde ventriculaire droite positionn\u00e9e au niveau de l\u2019infundibulum pulmonaire; r\u00e9cidive de syncopes quelques semaines apr\u00e8s l\u2019implantation","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"probable surd\u00e9tection atriale","quiz_answer_2":"probable surd\u00e9tection ventriculaire","quiz_answer_3":"d\u00e9faut de capture ventriculaire permanent","quiz_answer_4":"d\u00e9faut de capture ventriculaire intermittent","quiz_answer_5":"sous-d\u00e9tection atriale","correct_answer":["D"],"ecg_image":10124,"ecg_description":"Ce trac\u00e9 montre une d\u00e9tection correcte de l\u2019activit\u00e9 sinusale suivie d\u2019une stimulation ventriculaire avec capture; sur un battement, stimulation ventriculaire inefficace sans capture;","ecg_info_box":"Chez un patient implant\u00e9 d\u2019un stimulateur, une pause ventriculaire peut survenir dans le cadre 1) d\u2019un algorithme sp\u00e9cifique pour r\u00e9duire le pourcentage de stimulation ventriculaire tol\u00e9rant l\u2019existence de pauses ventriculaires et d\u2019ondes P bloqu\u00e9es; 2) d\u2019une surd\u00e9tection ventriculaire (myopotentiels, potentiels de rupture, interf\u00e9rences ...) inhibant la stimulation (absence d\u2019art\u00e9fact de stimulation) ; 3) d\u2019une stimulation inefficace en rapport avec une \u00e9l\u00e9vation de seuil (art\u00e9fact de stimulation non suivi d\u2019une d\u00e9polarisation ventriculaire).","commentary_ecg":"-","ecg_info_post_answer":"<img class=\"alignnone wp-image-10419 size-full\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-7-ecg2.png\" alt=\"\" width=\"873\" height=\"751\" \/>\r\n\r\n<strong>Description trac\u00e9<\/strong>\r\n\r\nL\u2019EGM confirme l\u2019absence de capture ventriculaire avec sur unbattement, \u00e9chappement jonctionnel;\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10420 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-7-ecg3-scaled-e1775144156502-1024x605.jpeg\" alt=\"\" width=\"800\" height=\"473\" \/>\r\n\r\n<strong>Description trac\u00e9<\/strong>\r\n\r\nTrac\u00e9 enregistr\u00e9 dans la continuit\u00e9 du premier; majoration du nombre de stimulations ventriculaires inefficaces;\r\n\r\n&nbsp;\r\n\r\n<strong>Commentaires<\/strong>\r\n\r\nCes trac\u00e9s mettent en \u00e9vidence une perte de capture ventriculaire intermittente chez un patient implant\u00e9 d\u2019un stimulateur double chambre dans le cadre d\u2019un bloc auriculo-ventriculaire complet et donc d\u00e9pendant de son stimulateur. Une perte intermittente de capture par \u00e9l\u00e9vation du seuil de stimulation ventriculaire entraine la survenue de syncopes avec un risque \u00e9lev\u00e9 de mort subite.\r\n\r\nLe seuil de stimulation correspond \u00e0 la plus petite impulsion \u00e9lectrique, d\u00e9livr\u00e9e en dehors de toutes les p\u00e9riodes r\u00e9fractaires naturelles, capable d\u2019engendrer la propagation d\u2019une d\u00e9polarisation. Il peut \u00eatre mesur\u00e9 en tension (volts) ou en largeur d\u2019impulsion (millisecondes). La d\u00e9termination du seuil de stimulation est d\u2019une importance majeure, car la programmation de la tension et de la dur\u00e9e d\u2019impulsion conditionne la marge de s\u00e9curit\u00e9 et d\u00e9termine la consommation \u00e9nerg\u00e9tique de la proth\u00e8se et donc la rapidit\u00e9 d\u2019usure des batteries. Il est g\u00e9n\u00e9ralement recommand\u00e9 de programmer une marge de s\u00e9curit\u00e9 de 100 % qui correspond \u00e0 une tension double du seuil. Cette marge de s\u00e9curit\u00e9 est destin\u00e9e \u00e0 prendre en compte les variations circadiennes du seuil de stimulation influenc\u00e9 variablement d\u2019un sujet \u00e0 l\u2019autre par le sommeil, la prise de repas, l\u2019activit\u00e9 physique, la fi\u00e8vre\u2026\r\n\r\nIl est possible de programmer aujourd\u2019hui dans tous les stimulateurs modernes une fonction de mesure automatique du seuil ventriculaire plus ou moins associ\u00e9e \u00e0 une adaptation automatique de l\u2019amplitude de stimulation avec v\u00e9rification cycle \u00e0 cycle de l\u2019efficacit\u00e9 de la capture (mod\u00e8le de l\u2019Autocapture permettant de d\u00e9livrer des amplitudes tr\u00e8s proches du seuil avec stimulation de s\u00e9curit\u00e9 \u00e0 haute amplitude si perte de capture) ou adaptation pour des dur\u00e9es prolong\u00e9es apr\u00e8s r\u00e9alisation planifi\u00e9e de contr\u00f4les de seuil mais sans v\u00e9rification cycle \u00e0 cycle (mod\u00e8le de l\u2019Autoseuil n\u00e9cessitant des marges plus importantes). Pour les 5 grandes compagnies, l\u2019\u00e9valuation de la capture ventriculaire est bas\u00e9e sur l\u2019analyse de la r\u00e9ponse \u00e9voqu\u00e9e (diff\u00e9rentiation entre polarisation et r\u00e9ponse \u00e9voqu\u00e9e). Pour les stimulateurs Biotronik, Boston Scientific et St. Jude Medical, il existe un contr\u00f4le cycle \u00e0 cycle de l\u2019efficacit\u00e9 de la capture ventriculaire permettant de d\u00e9livrer des amplitudes tr\u00e8s proches du seuil mesur\u00e9. Pour les stimulateurs Medtronic et Sorin, le seuil est mesur\u00e9 de fa\u00e7on p\u00e9riodique avec adaptation de l\u2019amplitude en fonction de cette mesure sans v\u00e9rification cycle \u00e0 cycle de la capture, n\u00e9cessitant des marges de s\u00e9curit\u00e9 plus importantes.\r\n\r\nCe patient a b\u00e9n\u00e9fici\u00e9 d\u2019une augmentation de l\u2019amplitude de stimulation (augmentation de 2.5 \u00e0 4 Volts pour un seuil \u00e0 2.6 V) ce qui a permis de supprimer les sympt\u00f4mes.\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n<img class=\"alignnone wp-image-10421 size-large\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/04\/trace-4-7-ecg4-scaled-e1775144239929-1024x609.jpeg\" alt=\"\" width=\"800\" height=\"476\" \/>\r\n\r\n<strong>Description trac\u00e9<\/strong>\r\n\r\nL\u2019interrogation confirme l\u2019\u00e9l\u00e9vation du seuil ventriculaire droit; ce trac\u00e9 est enregistr\u00e9 apr\u00e8s augmentation de l\u2019amplitude de stimulation et montre une capture effective permanente;"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Trac\u00e9 4.7: Perte de capture 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-4-7-perte-de-capture-ventriculaire\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 4.7: Perte de capture ventriculaire - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-09T09:47:43+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1515\" \/>\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-4-7-perte-de-capture-ventriculaire\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/\",\"name\":\"Trac\u00e9 4.7: Perte de capture ventriculaire - Cardiocases\",\"isPartOf\":{\"@id\":\"https:\/\/cardiocases.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg\",\"datePublished\":\"2026-04-02T15:37:54+00:00\",\"dateModified\":\"2026-04-09T09:47:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage\",\"url\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg\",\"contentUrl\":\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg\",\"width\":2560,\"height\":1515},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/cardiocases.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Trac\u00e9 4.7: Perte de capture 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 4.7: Perte de capture 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-4-7-perte-de-capture-ventriculaire\/","og_locale":"fr_FR","og_type":"article","og_title":"Trac\u00e9 4.7: Perte de capture ventriculaire - Cardiocases","og_url":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/","og_site_name":"Cardiocases","article_modified_time":"2026-04-09T09:47:43+00:00","og_image":[{"width":2560,"height":1515,"url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.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-4-7-perte-de-capture-ventriculaire\/","url":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/","name":"Trac\u00e9 4.7: Perte de capture ventriculaire - Cardiocases","isPartOf":{"@id":"https:\/\/cardiocases.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage"},"image":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage"},"thumbnailUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg","datePublished":"2026-04-02T15:37:54+00:00","dateModified":"2026-04-09T09:47:43+00:00","breadcrumb":{"@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#primaryimage","url":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg","contentUrl":"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/03\/trace-4-7-ecg-5-scaled-e1775143785996.jpeg","width":2560,"height":1515},{"@type":"BreadcrumbList","@id":"https:\/\/cardiocases.com\/ecg_case\/trace-4-7-perte-de-capture-ventriculaire\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/cardiocases.com\/"},{"@type":"ListItem","position":2,"name":"Trac\u00e9 4.7: Perte de capture 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\/10125","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\/10124"}],"wp:attachment":[{"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/media?parent=10125"}],"wp:term":[{"taxonomy":"ecg_case_type","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/ecg_case_type?post=10125"},{"taxonomy":"language_ecgcase","embeddable":true,"href":"https:\/\/cardiocases.com\/fr\/wp-json\/wp\/v2\/language_ecgcase?post=10125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}