{"id":10145,"date":"2026-04-02T19:30:06","date_gmt":"2026-04-02T19:30:06","guid":{"rendered":"https:\/\/cardiocases.com\/?post_type=ecg_case&p=10145"},"modified":"2026-04-02T19:30:07","modified_gmt":"2026-04-02T19:30:07","slug":"trace-5-1-extrasystole-atriale","status":"publish","type":"ecg_case","link":"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-5-1-extrasystole-atriale\/","title":{"rendered":"Trac\u00e9 5.1: Extrasystole atriale"},"content":{"rendered":"","protected":false},"featured_media":10144,"template":"","ecg_case_type":[254],"language_ecgcase":[259],"class_list":["post-10145","ecg_case","type-ecg_case","status-publish","has-post-thumbnail","hentry","ecg_case_type-extrasystoles","language_ecgcase-french"],"acf":{"ecg_case_title":"Trac\u00e9 5.1: Extrasystole atriale","patient_description":"Homme de 63 ans sans ant\u00e9c\u00e9dent particulier","quiz_question":"Sur cet ECG, on retrouve:","quiz_answer_1":"un rythme de base sinusal","quiz_answer_2":"2 extrasystoles atriales","quiz_answer_3":"un big\u00e9minisme atrial","quiz_answer_4":"2 extrasystoles ventriculaires","quiz_answer_5":"un syndrome de Wolf-Parkinson-White","correct_answer":["A","B"],"ecg_image":10144,"ecg_description":"L\u2019activit\u00e9 atriale est sinusale avec une dur\u00e9e normale de l\u2019espace PR et du QRS; on retrouve sur ce trac\u00e9, 2 extrasystoles atriales (battements atriaux pr\u00e9matur\u00e9s et ectopiques) provenant de la partie basse de l\u2019oreillette (probablement proche du sinus coronaire) car activit\u00e9 atriale n\u00e9gative dans les d\u00e9rivations inf\u00e9rieures; les QRS suivant ces extrasystoles sont fins et identiques aux complexes sinusaux; le PR est relativement court, le foyer ectopique \u00e9tant localis\u00e9 proche de la jonction auriculo-ventriculaire; repos partiellement compensateur sur le cycle suivant l\u2019extrasystole; ","ecg_info_box":"Une extrasystole atriale correspond \u00e0 une activit\u00e9 \u00e9lectrique atriale ectopique et pr\u00e9matur\u00e9e. Habituellement, le QRS qui suit est fin mais il peut \u00eatre large en pr\u00e9sence d\u2019un bloc de branche pr\u00e9existant ou d\u2019une aberration de conduction (bloc fonctionnel).","commentary_ecg":"Une extrasystole atriale (onde P\u2019) correspond \u00e0 une activit\u00e9 atriale pr\u00e9matur\u00e9e et ectopique c\u2019est \u00e0 dire se produisant pr\u00e9cocement par rapport \u00e0 l\u2019activit\u00e9 sinusale (P) et naissant en dehors du n\u0153ud sinusal. Le cycle PP\u2019 est donc plus court que le cycle PP et la morphologie de l\u2019onde P\u2019 (variable en fonction de l\u2019origine) est diff\u00e9rente de celle de l\u2019onde P sinusale. \r\n\r\nSur ce trac\u00e9, l\u2019extrasystole atriale nait dans la partie basse de l\u2019oreillette droite pr\u00e8s du n\u0153ud auriculo-ventriculaire ce qui explique la n\u00e9gativit\u00e9 dans les d\u00e9rivations inf\u00e9rieures et l\u2019aspect de P\u2019R relativement court. \r\n\r\nLes extrasystoles atriales sont exceptionnellement interpol\u00e9es (extrasystole ne modifiant pas le cycle PP) et dans une majorit\u00e9 de cas, l\u2019extrasystole atriale modifie le moment de survenue de l\u2019onde P suivante. La d\u00e9polarisation atriale ectopique se transmet au n\u0153ud sinusal qu\u2019elle p\u00e9n\u00e8tre et recycle entrainant une pause post- extrasystolique. Quand l\u2019extrasystole est \u201ctardive\u201d, le n\u0153ud sinusal se d\u00e9polarise mais l\u2019activit\u00e9 sinusale n\u2019est pas conduite, l\u2019activit\u00e9 sinusale qui suit n\u2019est pas modifi\u00e9e et survient apr\u00e8s un d\u00e9lai correspondant \u00e0 la dur\u00e9e exacte de son cycle habituel, la pause qui suit est alors parfaitement compensatrice. \r\n\r\nL\u2019intervalle P\u2019R qui suit l\u2019extrasystole d\u00e9passe g\u00e9n\u00e9ralement 120 ms ce qui permet de faire le diagnostic diff\u00e9rentiel avec une extrasystole jonctionnelle (survenue plus ou moins simultan\u00e9e de l\u2019onde P et du QRS). L\u2019espace P\u2019R peut \u00eatre allong\u00e9 si du fait de sa pr\u00e9maturit\u00e9, l\u2019extrasystole trouve le n\u0153ud en p\u00e9riode r\u00e9fractaire relative. \r\n\r\nL\u2019impulsion extrasystolique est habituellement normalement conduite par les voies de conduction auriculo-ventriculaire, la d\u00e9polarisation ventriculaire se faisant simultan\u00e9ment de fa\u00e7on physiologique par les 2 branches, le complexe QRS qui suit l\u2019extrasystole est g\u00e9n\u00e9ralement fin et non modifi\u00e9. Le QRS peut toutefois \u00eatre large et non modifi\u00e9 chez les patients avec bloc de branche pr\u00e9existant. Une aberration de conduction avec bloc de branche fonctionnel, due \u00e0 une anticipation de l\u2019influx trouvant une branche ou une h\u00e9mibranche en p\u00e9riode r\u00e9fractaire, peut \u00e9galement survenir quand l\u2019extrasystole est tr\u00e8s pr\u00e9coce, que le cycle pr\u00e9c\u00e9dent est lent et que la conduction n\u2019a pas \u00e9t\u00e9 ralentie au niveau du n\u0153ud auriculo-ventriculaire. De m\u00eame, l\u2019extrasystole atriale peut \u00eatre bloqu\u00e9e (non suivie d\u2019un QRS), l\u2019onde d\u2019activation ectopique rencontrant le n\u0153ud auriculo-ventriculaire en p\u00e9riode r\u00e9fractaire absolute. \r\n","ecg_info_post_answer":"\"\""},"yoast_head":"\nTrac\u00e9 5.1: Extrasystole 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-5-1-extrasystole-atriale\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Trac\u00e9 5.1: Extrasystole atriale - Cardiocases\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cardiocases.com\/fr\/ecg_case\/trace-5-1-extrasystole-atriale\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiocases\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-02T19:30:07+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-5-1-extrasystole-atriale\/\",\"url\":\"https:\/\/cardiocases.com\/ecg_case\/trace-5-1-extrasystole-atriale\/\",\"name\":\"Trac\u00e9 5.1: Extrasystole atriale - 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