{"id":10135,"date":"2026-04-02T19:11:41","date_gmt":"2026-04-02T19:11:41","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10135"},"modified":"2026-04-02T19:11:45","modified_gmt":"2026-04-02T19:11:45","slug":"trace-4-11-absence-de-repli-sur-arythmie-atriale","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-4-11-absence-de-repli-sur-arythmie-atriale\/","title":{"rendered":"Trac\u00e9 4.11: Absence de repli sur arythmie atriale"},"content":{"rendered":"","protected":false},"featured_media":10134,"template":"","ecg_case_type":[253],"language_ecgcase":[259],"class_list":["post-10135","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 4.11: Absence de repli sur arythmie atriale","patient_description":"Homme de 78 ans, implant\u00e9 d\u2019un stimulateur double chambre dans le cadre d\u2019une maladie de l\u2019oreillette; hospitalisation pour palpitations et signes de d\u00e9compensation cardiaque","quiz_question":"Concernant cet ECG, quelle(s) est(sont) la(les) r\u00e9ponse(s) vraie(s)?","quiz_answer_1":"tachycardie ventriculaire","quiz_answer_2":"ventricules stimul\u00e9s","quiz_answer_3":"ventricules d\u00e9tect\u00e9s","quiz_answer_4":"tachycardie par r\u00e9entr\u00e9e \u00e9lectronique","quiz_answer_5":"fibrillation auriculaire et stimulation ventriculaire rapide","correct_answer":["B","E"],"ecg_image":10134,"ecg_description":"Tachycardie \u00e9lectro-entrain\u00e9e ; stimulation ventriculaire rapide et irr\u00e9guli\u00e8re (peu compatible avec une TRE qui est r\u00e9guli\u00e8re); probable fibrillation auriculaire;","ecg_info_box":"Une tachycardie \u00e9lectro-entrain\u00e9e au niveau des ventricules, irr\u00e9guli\u00e8re et oscillant autour de la fr\u00e9quence maximale de suivi, chez un patient implant\u00e9 d\u2019un stimulateur double chambre doit faire \u00e9voquer la survenue d\u2019une fibrillation auriculaire et une d\u00e9programmation ou un dysfonctionnement de l\u2019algorithme de repli (commutation de mode).","commentary_ecg":"La prise en charge des patients porteurs d\u2019un stimulateur cardiaque pr\u00e9sentant des \u00e9pisodes d\u2019arythmie atriale est complexe du fait des diff\u00e9rents types de m\u00e9canismes connus pour d\u00e9clencher les arythmies atriales et du risque d\u2019emballement de la stimulation ventriculaire sur la d\u00e9tection d\u2019un rythme atrial rapide.\r\n\r\nLe dispositif peut \u00eatre programm\u00e9 pour qu\u2019il r\u00e9agisse \u00e0 une arythmie atriale en passant \u00e0 un mode asynchrone afin d\u2019\u00e9viter une stimulation ventriculaire \u00e0 fr\u00e9quence \u00e9lev\u00e9e pouvant compromettre la stabilit\u00e9 h\u00e9modynamique. La commutation de mode correspond \u00e0 la capacit\u00e9 du stimulateur \u00e0 commuter automatiquement d\u2019un mode de suivi atrial (DDD ou VDD) vers un mode sans suivi atrial (DDI ou VDI). La fr\u00e9quence de stimulation ventriculaire passe progressivement de la fr\u00e9quence maximale synchrone \u00e0 la fr\u00e9quence asservie ou la fr\u00e9quence de base. Cela \u00e9vite une chute brutale de la fr\u00e9quence ventriculaire. Lorsque la tachyarythmie atriale se termine, la commutation de mode renvoie au mode de stimulation synchrone programm\u00e9.\r\n\r\nLa commutation de mode est programm\u00e9e en nominal et ne doit pas \u00eatre d\u00e9programm\u00e9e m\u00eame si le patient ne pr\u00e9sente pas d\u2019ant\u00e9c\u00e9dent connu d\u2019arythmie atriale. Chez ce patient, l\u2019absence de repli est associ\u00e9e avec une stimulation ventriculaire rapide prolong\u00e9e \u00e0 la fr\u00e9quence maximale de suivi. L\u2019association perte de la systole auriculaire et emballement de la stimulation ventriculaire est responsable des signes de d\u00e9compensation cardiaque observ\u00e9s.\r\n\r\nLa programmation du repli chez ce patient est n\u00e9cessaire pour \u00e9viter la synchronisation ventriculaire sur l\u2019activit\u00e9 atriale rapide.","ecg_info_post_answer":"\"\"\r\n\r\nDescription trac\u00e9<\/strong>\r\n\r\nL\u2019EGM montre la d\u00e9tection d\u2019un rythme atrial rapide et irr\u00e9gulier avec stimulation ventriculaire permanente; absence de repli suite \u00e0 la d\u00e9tection d\u2019une fibrillation auriculaire expliquant la stimulation ventriculaire rapide;"},"yoast_head":"\nTrac\u00e9 4.11: Absence de repli sur arythmie atriale - 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-4-11-absence-de-repli-sur-arythmie-atriale\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 4.11: Absence de repli sur arythmie atriale - 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